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During the months of August, September, October and November
the disease was more prevalent, but even at this time it did not
assume the proportions of a serious epidemic. The above figures
show a slight improvement in the incidence of this disease in the
Borough on that of 1901. The number of genuine cases notified
during the latter year was 186. The attack rate for 1902 is therefore
.8 per 1.000 living persons. The largest number of cases occurred in
the Central and South-East Sub-districts, the notifications in these
being respectively 59 and 57. The cases removed to hospital
numbered 122, which is equal to 65 per cent. of the total.
The deaths from this disease numbered 27, which gives a deathrate
of 15 per cent. of those attacked and .12 per 1,000 living.
Each year's experience strengthens my conviction that cases of
typhoid fever should not be treated at home unless under special
circumstances, with ample accommodation and the attendance of a
trained nurse. During the year we have had several cases treated at
home in poor families, and nursed by untrained relatives. Almost
invariably secondary cases, usually the nurse, occur. In one instance
we had four secondary from such a case. The lamentable point
about these cases is, that the advice to be treated at home emanates
usually from the medical attendant.
There were nine cases of typhoid during the year attributed by the
relatives of the patients to the consumption of shell-fish ; but I had
nothing beyond the statement of these relatives to support the connection
of the disease with shell-fish.
Typhus.—No case of this disease appeared in the Borough during
1902.
Continued Fever.—Six cases were notified under this heading
during the year 1902, one of which was removed to the fever hospitalThere
were no deaths from this disease.
Puerperal Fever.—Sixteen cases of this disease were notified
during 1902, and of these 4 died. The mortality is equal to 25 per
cent. of cases attacked. The attack-rate per 1,000 births is 2.5 and
mortality .6 per 1,000 births.