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in prevalence of the disease. Other forms of streptococcal
infection did not appear to share in this
decline, and notifications of puerperal pyrexia were
higher. The incidence of Diphtheria was low, but the
mortality was relatively high owing to a number of
cases of virulent infection. The principal enteric
infection was a mild Dysentery of the Sonne Type
which became prevalent in November. There were
two cases of Anterior Poliomyelitis, and recovery in
both has been almost complete. One acute case of
cerebro-spinal fever of a sporadic type ended fatally.
Three cases of Opthalmia Neonatorum were notified
during the year.

Scarlet Fever.—One hundred and fifty-nine cases
were notified. Of these, eight were institution cases.
The disease was generally mild, but there was a
higher proportion of more severe cases suggesting an
increase of virulence of the causative organism with
the decline in the epidemic wave. The highest numbers
of cases were again in the West Central and NorthEast
Wards which, with the North and East-Central
Wards, contributed sixty-eight per cent, of the cases.
The case rate for the Borough was 2 02 per 1,000 of
population compared with a case rate of 2 33 for England
and Wales. Thirty of the one hundred and fiftyone
district cases were nursed at home. Twelve secondary
cases of infection occurred after removal of
patients to hospital, and there were six "return" cases
related to infection by patients discharged. The prevention
of secondary cases depends on speedy isolation
in the home or removal of any suspected cases.
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