View report page

11
diphtheria case-rate for 1897 is 29.6 per 10,000. Out of the total of
313 cases of diphtheria and membranous croup notified in Chelsea,
71 belonged to Kensal Town, the share of the latter district in
proportion to its population being 69 cases. Chelsea's diphtheria case-rate
in 1897 was slightly exceeded by only one parish, that of Fulham,
in West London, all the other parishes having case-rates below that of
Chelsea.
In the home district the cases were fairly equally divided amongst
the several mouths, but 129 cases occurred in the first six months and
only 111 in the last half of the year, contrary to what usually occurs in
the behaviour of diphtheria, which has a marked seasonal preference for
the autumn months. This is, no doubt, to be attributed to the
influence of the epidemio in the latter half of 1896. In Kensal Town
10 cases occurred in the first quarter of the year, 21 cases in the second
quarter, 10 cases in the third quarter, and 32 cases in the fourth quarter.
The percentage of cases of school age (3 to 13 years) was 61.7 per
cent, in Chelsea, 57.0 per cent, in the home district, and 77.5 per cent,
in Kensal Town. The fall in notified cases following the closure of the
schools was not at all marked until the thirty-third week of the year,
some three weeks after school closure, but from the thirty-third to the
thirty-fifth week only three cases at school age were notified, as against
11 in the proceeding three weeks. The diminution of diphtheria
notifications in London usually commences iu the thirty-third week
and continues to the thirty-sixth, and is, no doubt, dependent on
antecedent school closure in the thirtieth week. In 1897 the board
schools closed on July 22nd, which is about a week earlier than usual.
Enteric Fever. —The number of cases of enteric fever in 1897
(including one notified as continued fever, which was subsequently
ascertained to be enteric) was 53. The cases annually notified since
1890 are as follows:—1890, 63 cases; 1891, 46 cases; 1892, 44 cases;
1893, 77 cases; 1894, 95 cases; 1895, 76 cases; 1896, 68 cases;
1897, 53 cases. The number of cases in Kensal Town in 1897 was 10,
Kensal Town's proportion of the total 53 cases being 12. The number
of cases notified in the first quarter of the year in Chelsea was 17; in
the second quarter, 5 ; in the third quarter, 17; in the fourth quarter,
14. There were no cases attributable to the Maidstone epidemic, but
in one case the infection was probably acquired whilst the patient was
in residence at King's Lynn. In three other cases the infection was
probably acquired outside the parish, whilst in three cases the patients
were inmates of Nursing Homes in the pariah, and were infected
outside the parish. This leaves 46 cases in which the infection was
probably acquired in the parish.
The following Table IX. shows the case mortality, or percentage
of deaths to notifications of scarlet fever, diphtheria (including membranous
croup), and enteric fever in Chelsea, and in London, in each of
the eight years, 1890-97.