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decrease on the numbers in previous years being 96 as compared with 136 in 1897,
135 in 1896, 117 in 1895, 123 in 1894, 231 in 1893, 119 in 1892 and 129 in 1891.
There is a marked decrease in the numbers of deaths from scarlet fever and diphtheria.
The deaths from puerperal fever and erysipelas are increased. The deaths from
infectious diseases which are notifiable were at the rate of 0.79 per 1,000 inhabitants
in Shoreditch, whilst the deaths from the principal zymotic diseases which are
not notifiable, viz.; measles, whooping cough and diarrhoea were at the rate of 3.3
per 1,000 inhabitants.
METROPOLITAN ASYLUMS BOARD.
The infectious diseases which are receivable into the hospitals of the Board are
smallpox, scarlet fever, fever (enteric and typhus) and diphtheria. The cases of these
diseases certified in Shoreditch numbered 776* and the number removed for treatment
to hospital was 682†.
The vast majority of the cases were removed to hospitals of the Metropolitan
Asylums Board. Of the infectious cases receivable into hospitals, 81.4 per cent were
removed to hospital as compared with 71.4 in 1897, 65 in 1896, 57.7 in 1895 and 61.0
in 1894.
No difficulty, by reason of the exhaustion of the accommodation in the Board's
hospitals, was experienced in Shoreditch during 1898 in securing the prompt removal
of patients. It was intimated by the Board in November that there was reason for
anticipating that the pressure on the Board's accommodation might necessitate the
temporary refusal of diphtheria cases. The necessary arrangements were made with
respect to supplying antitoxic serum for the early treatment of such cases at home,
as indicated in the Annual Report of last year. Fortunately, however, the necessity
did not arise.
Four instances of recurrence of scarlet fever following upon the return of patients
from hospitals of the Metropolitan Asylums Board came under observation during
1898. In one instance there was strong evidence pointing to the occurrence of a
second case in the family being due to the return of a patient from the fever hospital
whilst still in an infectious condition. In the other cases although the circumstances
were suspicious, there was not sufficient evidence to warrant such a conclusion being
drawn.
An investigation on behalf of the Metropolitan Asylums Board is now being
conducted with a view to obtaining definite and detailed information with respect to
cases of scarlet fever and diphtheria which occasionally occur in homes shortly after
the return of patients who have been suffering from these diseases and who have been
treated in the fever hospitals of the Board.
* This number does not include 3 certificates as to scarlet fever, 1 as to enteric fever, and 1 as
to typhus fever, which were received but subsequently cancelled at the request of the medical
practitioners.
† Fifteen of these cases, viz.—8 diphtheria, 3 scarlet fever and 4 enteric fever, were found after
sojourning in hospital not to be in the opinion of the medical officers suffering as certified.