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32
DIPHTHERIA.
Incidence.
85 notifications were received during the year, the diagnosis,
however, being revised in 31 instances, most commonly to acute
tonsillitis. 54 cases in a population of 189,300 is a rate per thousand
of 0-3, as compared with that of 1-14 for the country as a whole.
This is the tenth consecutive year in which a low incidence has
prevailed.
In the first quarter there were 22 cases ; in the second, 10;
in the third, 8 ; while the incidence rose in the last quarter, when
19 cases were notified.
Secondary infections occurred in three households.
One patient was a return case from a patient treated in the
hospital of another authority ; two patients were bacteriological
cases, while three were suffering from nasal diphtheria.
Place of Treatment.
All but seven of the cases notified were admitted to the South
Harrow Isolation Hospital.
Deaths.
Nine deaths were recorded as due to diphtheria.
Immunization.
Although the two-dose A.P.T. method was approved, most
practitioners treating children in the district continued to favour
the use of T.A.M. as an antigen, though this involved three
inoculations.
1129 children completed treatment during the year. Of the 665
offered facilities, 355 attended for post-Schick testing, of whom
6 reacted positively.
Provision of Anti-toxin.
In order to facilitate the early administration of diphtheria
anti-toxin in cases, or suspected cases, arrangements were made
for the serum to be distributed not only from the two isolation
hospitals, but also from the different fire stations. The medical
practitioners were circularised to the effect that they could obtain
serum in this way, and that by virtue of Section 113 of the Middlesex
County Council (General Powers) Act, 1938, the serum could
be used for any patients and not be limited, as under the Diphtheria
Anti-toxin Order, to the poorer inhabitants of the district.
69 lots were issued during the year, totalling 552,000 units.
SCARLET FEVER.
Incidence.
325 cases were notified during the year, of which 9 were errors
of diagnosis—4 of these suffering from tonsillitis, 4 from rashes,
and one from an axillary abscess. 316 cases represent an incidence