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16
In the home district, the largest number of cases notified in any
one month was in July (20 notifications). In August there were only
3 notifications of the disease—the smallest number of any month in the
year—this reduction being undoubtedly due to the school holidays, and
the absence of many children from London. After the first week in
September, when the schools had recommenced, there was a marked
recrudescence of the disease. In the three weeks ending the 1st
September, only one caso of diphtheria had been notified in the entire
parish—showing a greater freedom from this complaint than has
prevailed for many years past.
The percentage of cases of school age (3 to 13 years) was 66 per
cent, in Chelsea, 60 per cent, in the home district, and 67 per cent, in
Kensal Town.
During March, April, and the early part of May, a large
proportion—over 60 per cent.—of the cases of diphtheria notified in the
home district were children attending or living in the same house with
a child attending a Board School in the central portion of the parish—
the same school that was concerned in the propagation of the epidemic
in 1896. The majority (13) of these children were attending the
infants' department, 2 were in the girls', and 1 in the boys' department.
Cases occurred in 5 out of 7 of the class-rooms in the infants' department.
No cases occurred in connection with the 6chool after the 13th May.
I wrote to the Medical Officer of the London School Board suggesting
the closing of the infants' department, and the disinfection of the
5 class-rooms concerned; but shortly afterwards the outbreak was at
an end, and I believe it was not considered necessary to take any
further action.
During September, 4 cases of diphtheria were notified in the
persons of children attending one of the Church Schools. In this
instance also the infection appears to have spread from one child to
another during school attendance, although an interval of a week
elapsed between the successive cases; that is to say, in each case there
was an interval of a week between the day on which a girl was absent
from school for illness, subsequently notified as diphtheria, and the day
on which the next case absented herself for a similar reason.
During the year 5 cases notified as diphtheria which were sent to
the M.A.B. Hospitals, were subsequently stated not to be suffering from
the disease.
Prevalence of Scarlet Fever, Diphtheria, and Enteric Fever
in West London.
The following table XI. is based upon the notified cases of scarlet
fever, diphtheria and membranous croup, and enteric fever, respectively,
in each of the eight parishes constituting West London, the rates being
calculated upon the estimated population of each district.