View report page

15
Five out of the 17 primary cases terminated fatally, and three of
the 17 secondary cases, making a total of 8 deaths out of 34 cases (case
mortality=23.2 per cent.)
Perhaps the most remarkable feature of the outbreak was its
extremely localised nature; nearly all of the 13 houses primarily
invaded being within 100 yards of a common centre.
The case-rate per 10,000 of the population in the home district
was only 5.0 in 1900, as compared with 5.7 per 10,000 for 1899.
These are exceptionally low rates. The Kensal Town rate, owing to
the outbreak above alluded to, was 20.8 per 10,000. Out of the
38 cases occurring in the home district in 1900, in 7 the infection was
probably acquired outside London. Twenty-two out of the 38 cases
were notified in the fourth quarter of the year.
Typhus.—The case of typhus notified the 5th September, was that of
a nurse in the Chelsea Infirmary, who was taken ill about the end of
August. Tho case was seen by me in consultation with the medical
officers of the Infirmary, and was a typical case of the disease. It was
not possible to trace exactly tho source of infection, but a case of typhus
was under treatment in the Paddington Infirmary from the 8th to
the 14th August, that being the only possible source of infection,
so far as known. There was no spread from this case to other nurses
in the Infirmary.
Only seven cases of typhus were notified in the whole of London
during 1900.
Scarlet Fetcr.—This disease was less prevalent in Chelsea in 1900
than in 1899,tho case rate per 10,000 of the population being 239 in 1900,
as against 29.1 in 1899. Tho case-rate for West London was 27.0 per
10,000, and for London generally 30.0 per 10,000. The disease was prevalent
to a slightly less extent in Kensal Town than in the home district, tho
case-rates being respectively 22.2 and 244. The autumnal exacerbation
in prevalence of scarlet fever in Chelsea in 1900 was only slightly
marked. A very early decline set in after the 2nd week in November,
which was followed by an unusual increase in cases in the latter half of
December. Tho fall in notified cases following the closure of the
schools (Board Schools on the 26th July), was well marked. Only
5 cases at school age (3 to 13 years) wore notified in the four weeks
following school closure as against 16 and 18 school-age cases in the
two preceding four weekly periods. Tho percentage of cases of school
ago was 66 per cent, in Chelsea, 66 per cent, in the home district, and
68 per cent, in Kensal Town.
Diphtheria.—There was again a diminution in the prevalence of
this disease in Chelsea in 1900, as compared with 1899, the case-rate
per 10,000 of the population being only 18.7, as against 24.4 in 1899.
n the home district, the diphtheria caso-rate in 1900 was 19.8, as
against 18.0 in 1899. In Kensal Town, however, the diphtheria
prevalence was much diminished, the rato being only 14 6 per 10,000
in 1900, as against 47.1 in 1899.