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17
the chart furnished with this Report. The rise during the second
half of the year did not appear to be associated in Hackney with
any particular agency such as school, milk supply, etc.
It is very probable that outbursts arise from the multiplication of
mild and unrecognised cases, for which no precautions of isolation,
etc., are taken. In some of these cases the initial symptoms are
very slight, and the desquamation almost absent; consequently,
medical aid is not sought. I believe it is by means of these cases
that the prevalence of Scarlet Fever is maintained in the district, and
wide spread outbursts occasionally occur.
Diphtheria and Membranous Croup.—The past year has
shown a diminution of this disease as compared with 1898. The cases
of diphtheria notified numbered 644, and membranous croup 20.
The corresponding figures for 1898 were 847 and 19. Amongst the
number sent to hospital 20 were returned by the Medical Superintendent
as not suffering from any infectious disease. This reduces the
total cases to 846, which are equal to an attack-rate of 2.9 per 1,000
living. The deaths for the year numbered 84, and is equal to a deathrate
of .3 per 1,000 attacked. The disease was prevalent during
the whole year, but rose much above the average during the months of
February, March, June, November and December (see accompanying
chart).
1 could not trace this rise to any general agency, as school attendance,
or milk supplies, etc.
In the last report issued by the Asylum's Board the Medical
Superintendents, reporting upon the treatment of diphtheria by
antitoxin, state that "the figures for 1898 tally very closely with those
of the preceding year, and fully bear out the favourable opinion previously
expressed as regards the serum treatment."
This treatment is certainly finding favour with medical practitioners
in this district, to whom during the year 45 bottles were supplied
form the Public Health Department.