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Typhoid and Paratyphoid Fever.—No cases were
notified during the year.
Puerperal Pyrexia.—Eleven cases of Puerperal
Pyrexia were notified during the year. The case rate
was 8 94 per 1,000 total births, compared with 14 42
per 1,000 total births for England and Wales.
The early notification of cases of Puerperal Pyrexia
is of primary importance in the prevention of maternal
mortality. Medical practitioners should make the
fullest use of the consultant, bacteriological, and hospital
service provided by the Authority, and secure
immediate and effective isolation of any suspected
case occurring in a Maternity Home.
Dysentery—Fourteen cases of Dysentery of the Sonne
Type were notified. The cases were generally mild.
Their number was considerably reduced, but indicates
that the disease remains endemic. Control can only
be effected by strict attention to personal and domestic
hygiene and by the utmost care of all concerned in the
exposure, handling, and distribution of food.
Epidemic Catarrhal Jaundice.-On 8th December,
1938, seven cases of Catarrhal Jaundice were reported
from the Worcester Park district. Investigation
revealed sixteen cases, thirteen being children and
three adults. The sequence of cases in families and
in school showed the condition to be infectious.
The onset was gradual in the majority of cases and
early symptoms included, malaise, anorexia, headache,
pain in the chest and back, and muscular stiffness.
Vomiting was pronounced and followed in two to four
days by Jaundice. In a few cases a primary sickness
was followed by a quiescent period of a week, terminating
in vomiting and subsequent Jaundice. The
degree of sickness varied in members of the same
family. In some cases Jaundice was absent and
diagnosis based on known direct and intimate contact
with a confirmed case. The acute phase lasted for
from one to four days. There was pain in the
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