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therefore 0.80 as compared with 0.42 in 1899. The rate for
London as a whole during 1900 was 0.42 per 1,000.
Whooping Cough is a disease of about two months duration, and
is chiefly characterized by bronchial catarrh and a frequent
paroxysmal cough. It generally occurs as an epidemic late on in
the winter, say from December to March. Though no age is
absolutely exempt from whooping cough, it is essentially a children's
disease, most of the cases being met with in children under
seven years of age. It is most fatal in the second year of life.
The disease is almost entirely spread directly from patient to
patient, the patient being infectious from the very commencement
of the attack, and remaining so as long as the "whoop" is present.
Owing to this prolonged infectiousness, isolation of the patient
from other children should be enforced for at least six weeks from
the first "whoop." .
The above principles are generally accepted as well established,
and the experience of the disease in Finsbury in 1900 well
illustrate them. Out of the 53 deaths, 42 occurred in the first
half-year, and 27 in the first quarter. There were only 3 deaths
in the last quarter of the year. The eldest child in which the
disease proved fatal was 3 years old, the youngest was 2 months,
the average of the 53 deaths being 16 months. That the disease
is spread from patient to patient, particularly in crowded tenements,
is illustrated by the fact that out of the 52 dwellings where the
disease occurred 47 were tenement houses.
The means of preventing whooping-cough, which kills annually
in London some 2,000 children, are largely in the hands of the public.
Sufficiently long isolation of infected children and watchful care over
the infants' departments of the schools, are perhaps the main
points requiring attention.
Erysipelas.—Seventy-four cases of Erysipelas were notified in
1900 and there were 4 deaths. Seven out of the total number of
cases were treated in hospitals, but no cases were removed to the
hospitals of the Metropolitan Asylums Board by this Department.