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which give rise to these diseases are likely to he widely distributed, not
only in the homes but even in the months and nasal passages of the
children. Secondly, an attack of measles is either disregarded or badly
nursed in a large proportion of instances, and opportunities are thus
afforded for primary or secondary complications.
SCARLET FEVER (See Tables III., IV. and VI.).-Five hundred
and thirty-four cases were notified, of which five ended fatally. The
disease was less prevalent and also less fatal than in 1907, when
there were 661 cases with 11 deaths. The incidence of the South
Norwood district was again remarkably high, no less than 182 cases
having been notified in this Ward.
I am unable to offer any explanation of the high incidence in
the South Norwood district beyond the fact that the disease was of
an extremely mild type as shown by the case fatality and the consequent
occurrence of mild and unrecognisable cases.
RETURN C4SES OF SCARLET FEVER.—In 33 instances 54
other cases of Scarlet Fever arose in homes to which patients had
been discharged from hospital. The number of these cases was
exceptionally high during 1908, both in Croydon and elsewhere.
A considerable number of the secondary cases arose at long intervals,
subsequent to the discharge of the infecting cases. This
supplies further evidence of the fact that scarlet fever infection is in
certain children a very chronic process. At the moment we are
making further enquiries into the whole question of return cases,
but the material available is not sufficient for adequate discussion
at the present moment.
EPIDEMIC INFLUENZA was the assigned cause of death in 52
instances, as compared with 31 in 1907. The majority of the deaths
occurred in the first half of the year, 32 deaths being registered in
the quarter ending March 31st and a further 12 in the second quarter,
while only two occurred in the third quarter and six in the fourth
quarter.
WHOOPING COUGH accounted for 29 deaths, all of which
occurred in children under live years of age. The number of deaths
is slightly smaller than in 1907, when 32 were registered. The
number of cases is unknown, but was in all probability smaller than
in the previous year, as only 458 school notices were issued in
reference to this disease as compared with 578 in 1907.
DIPHTHERIA AND MEMBRANOUS CROUP.—The number of
cases notiried amounted to 405, as compared with 286 in 1907,
while 37 cases terminated fatally, as compared with 40 deaths in 1907.