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The intervals between the return of the scarlet fever cases and the onset of the diphtheria
were 2, 3, 4, 6, 7, 8, 8, 12, 21 and 24 days.
After-care.—A proportion of the children who have been discharged from hospital after
diphtheria have been visited to ascertain their condition and to secure treatment for sequelae
if necessary. 144 such children have been visited in 1921, of whom 116 are reported to have
recovered satisfactorily and 28 to have required treatment. The conditions needing
treatment were as follows : Debility 13, nose and throat 7, ears 2., paralysis 3, enlarged glands 1,
heart 1, cough 1. Eleven of the cases were treated at the St. Pancras Dispensary, 9 at hospitals,
1 at the School Clinics, and 7 by private doctors.
TYPHOID OR ENTERIC FEVER (INCLUDING PARATYPHOID).
Twenty-eight cases were notified during 1921 as suffering from this disease. Of these,
two were afterwards found not to be suffering from enteric, the number of actual cases being 26.
Two of these cases were fatal (one typhoid and one paratyphoid B), equal to a case mortality
of 8 per cent. (There was a third death from typhoid fever during the year in the person of
a St. Pancras resident who caught the disease and died while staying in another part of the country .
This case is not included in the 26.)
In 24 of the 26 cases information as to the serum (agglutination) reaction is available.
17 were reported as positive for B. typhosus, 4 for B. paratyphosus B, and 1 for B. paratyphosus
A, while 2 were negative, though diagnosed as typhoid on clinical grounds. (One case in which
the reaction was equally strongly positive for B. typhosus and B. paratyphosus is included in
the 17 for B. typhosus and not in the 4 for B. paratyphosus.)

One case occurred in January following upon a previous case in the same family at the
end of 1920; there were two instances in each of which three members of the same family
were reported; and the remaining 19 cases were all in separate houses.
The cases took their onset 2 in December, 1920, 1 in February, 1921, 3 in May, 3 in
June, 4 in July, 3 in August, 4 in September, 4 in October, and 2 in November.
Two of the cases (both typhoid) were non-parishioners staying in St. Pancras, who took
the infection at their homes before coming to London. Three others (two typhoid, one no
bacteriological information) were St. Pancras residents who probably took the infection while
staying out of London. [Two of these five cases who probably caught the disease out of London
had eaten shellfish, viz., cockles and periwinkles and whelks, respectively, and may have taken
the infection from that source.] Of the other cases, one (typhoid) was a hospital nurse who
had been nursing a case of typhoid fever; and two (one typhoid and one equally typhoid and