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of the cases certified, as compared with 3.1 in 1906, 3.4 in 1905, 3.8 in, 1904, 2.7 in
1903, 3.5 in 1901 and 54 in 1900. It was therefore below the average. Amongst
children under five years of age there weret 291 cases, with 21 deaths, the casemortality
being 7.2 per cent, (allowing for cases not regarded as scarlet fever at
the hospitals, 8 per cent.), as compared with 6 per cent, in 1906, 7.7 in 1905, 7.8
in 1904, 2.7 in 1903, 5.3 in 1902, 6.8 in 1901 and 12.0 in 1900. Among persons
over the age of five years there were 585 cases,, with 7 deaths, the mortality being
1.2 per cent, of the cases certified (allowing for cases not regarded as scarlet fever,
nearly 1.3), as compared with 1.3 in 1906, 1 in 1905, 1.8 in 1904, 2.7 in 1903 and
1.7 in 1901. These figures indicate how much more fatal scarlet fever is during early
life. Of the 28 deaths during 1907, 26 were of children under the age of ten years.
Mention may be made of a small localised outbreak of scarlet fever which
attracted attention during the year. On August 12th it was noticed that an unusual
number of cases were being certified from houses situate in Caesar and Long Streets.
During the course of the week ending August 12th 11 cases were certified in seven
houses in these streets. The existence of a common source of infection was suspected,
and enquiry was made in the neighbourhood where the cases were occurring, which
resulted in information being obtained that a child resident at a house in Caesar
Street had been unwell and that it had been noticed going about with hands rough
and peeling. The house was visited and the child was examined, and was found
to be desquamating and otherwise presenting evidence of a recent attack of scarlet
fever. The history was that the child was taken with sickness on July 29th, and
a sore throat was noticed on the following day. No rash was, however, observed,
and scarlet fever was not suspected. This child had been playing with children from
the houses invaded, and there is little doubt that it was the source of infection in
most of the cases. On the removal of this case to hospital the occurrence of the
cases in these streets at once came to an end.
The cases of scarlet fever certified in the Metropolis numbered 25,936, the attackrate
being 5.6 per 1,000 inhabitants, as compared with 4.3 in 1906, 4.1 in 1905,
2.8 in 1904, 2.7 in 1903, 3.9 in 1902, 4.4 in 1901 and 3.0 in 1900. ihe deaths
in the Metropolis from this disease numbered 644, as compared with 533 in 1906,
549 in 1905, 365 in 1904, 361 in 1903, 560 in 1902, 584 in 1901, and 361 in 1900,
the death-rate being 0.13 per 1,000, as compared with 0.11 in 1906, 0.11 in 1905,
0.08 in 1904, 0.07 in 1903, 0.12 in 1902, 0.13 in 1901, and 0.08 in 1900. The above
figures indicate that scarlet fever during 1907 was more than usually prevalent in
the Metropolis.
DIPHTHERIA (INCLUDING MEMBRANOUS CROUP).
The cases certified numbered 211, as compared with 133 in
1906. Of these, 46, or nearly 22 per cent., were not regarded
as diphtheria cases at the hospitals of the Metropolitan Asylums Board, the diagnosis