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II.—NOTIFICATION OF INFECTIOUS DISEASE.
In Table III. of Appendix will be found full particulars of the diseases notified in
Bermondsey during the fifty-two weeks ending January 2nd, 1904.
This year I have to report a great diminution in the total cases of infectious disease. The
number notified in 1903 was 867, against 1315 (exclusive of chicken pox) in 1902. This great
diminution is chiefly due to the practical cessation of the small-pox epidemic, and a great diminution
of cases of diphtheria and scarlet fever. The small-pox notifications numbered 7 against 219 in
1902, diphtheria 172 against 277, scarlet fever 400 against 491, enteric fever 76 against 125 in
1902.
The numbers for the sub-registration districts (exclusive of chicken-pox) were —for
Bermondsey, 1903, 575; 1902, 856; Rotherhithe, 1903, 186; 1902, 357 ; and St. Olave's, 1903,
106; 1902, 102.
This makes an attack rate per thousand inhabitants of 6.7 for the whole Borough; the
rate for the sub-districts being 7.0 Bermondsey, 4.8 Rotherhithe, 11.5 St. Olave's. The
corresponding figures for 1902 (chicken-pox excluded) were, the whole Borough 10.1; and 10.4,
9.3, 10.8 for the sub-districts respectively.
As 47 cases were returned as not suffering from the notified diseases, the above figures, in
calculating a net result, would require to be slightly reduced. As remarked in previous annual
reports, I am inclined to look upon the number of notifications, despite these errors of diagnosis,
as representing approximately the amount of infectious disease in the district. lam convinced
that numerous cases occur as mild attacks, and are often unrecognised either by the parents or
medical attendant as infectious. Many infectious diseases apparently originate in this way.
Small-pox.
There were 7 notifications of small-pox during the year, of which 6 were genuine cases,
and one was returned as not being small-pox. There were no deaths. The following are
particulars of the individual cases : —
March 14th. —R. N., 27, male, 6, Foxlow Street. Patient was vaccinated in infancy.
Source of infection could not be traced.
March 27th.—H. P., 41, male, Casual Ward, Rotherhithe. Patient was vaccinated in
infancy. Source of infection could not be traced
April 9th.—E. C., 14, female, Gillhams Court. Patient was vaccinated in infancy. Source
of infection could not be traced.
April 20th. —P. 0., 1½, Gillhams Court. This case was returned as not suffering from smallpox.
May Ist. —F. F., 19, male, Forsyth Street. Patient was vaccinated in infancy. He came
from a house in Ford Road, Poplar, in which several cases of small-pox had occurred.
May 5th. —A. E., 52, male, Weston Street. Patient was vaccinated in infancy. Source of
infection could not be traced.
October 22nd. —W. T. P., 39, male, Eugenia Road. Patient was vaccinated in infancy.
Source of infection could not be traced.
Typhus Fever.
Bermondsey, and what were originally the neighbouring Vestries and Districts, have
always been liable to outbreaks of typhus fever.
The latest occurred in 1899, in connection with houses in Minto and Weston Streets, and
amounted to 10 cases, nine of which belonged to Bermondsey. Special reference to this and
other outbreaks in London since then will be found in the Annual Reports of the Medical Officer
of the London County Council for this and subsequent years.
Only one case occurred in Bermondsey since 1899, viz., in Rothsay Street, at the southwest
end of the Borough, till the outbreak which is here recorded commenced in January,1908.convenience I have tabulated all the cases which occurred, with short notes of tbe
source of infection, etc., in the last column. I shall refer to the cases by their numbers in
co'umn 1. I also append a temperature chart to illustrate my remarks on some clinical aspects of
the disease. For the notes on which these are based I am indebted to the Medical Superintendents
of the South-Eastern and Brook Hospitals, where the cases were treated.
Case 1 occurred on January 20th, 1903, in Jamaica Road, at a fish shop, close to the
neighbourhood where the majority of the cases occurred, but I was unable to discover any
connection between this and the subsequent cases, since a cross-examination of the patients and
their friends failed to elicit that there had been any dealings between them and the occupiers of
the shop where the first case occurred. The patient was a fish porter, and may have contracted
the disease at Billingsgate.
Case 2 occurred 14 days later, on February 4th, in Stevens Street, about a mile and a
quarter from the first one. There was no traceable connection between the two. I wrote to the
Medical Officer of Health for the City of London, where the lad worked, but he could suggest no
source of infection. In both these cases the families were clean, in good circumstances, and
not over-crowded.
Case 3 occurred on February 22nd, after an interval of 18 days from the last case, in
Warford Place, quite close to Case 1, though the connection, if any, could not be traced. This
patient before removal was seen by several doctors, one of whom was an old resident in one of
the M.A.B. Hospitals. This gentleman informed me that the rash was scarlatiniform, and so
like scarlet fever, that he made up his mind to discard the history of the late appearance of the