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case was at business. The result was negative in both. I found, on communication
with the hospital where the notified cases were sent, that they were suffering from
genuine typhoid, and notwithstanding the result of the examination of the blood, I still
think there is good ground for believing that these illnesses were of similar if less severe
type to the three that were notified.
"If this is so, then the first case notified on January 19th arose from them, and
that in turn gave rise to the next two notified, as the families were on frequent visiting
terms with one another."
The fixing of the laboratory here referred to, was its removal from our old quarters in
Rotherhithe Town Hall, up to the Town Hall. Spa Road. Some doubt occurred later as to the
purity of the typhoid culture used here, so that the result of the inquiry does not preclude the
possibility mentioned in these reports.
Of the seven cases returned as not suffering from enteric, the diseases which were
mistaken for it were tubercular meningitis (2), diarrhoea ('2), lobar pneumonia (1) ; about 2 there
was no diagnosis recorded.
There were 16 deaths, which makes a case mortality of 24.2 per cent. This is unusually
high, since the average mortality in London is between 16 and 17 per cent., and shows that the
type of disease must have been very severe.
In the latter part of the year 1903 Dr. .J. King Warry, Medical Officer of Health for
Hackney, traced a number of cases of enteric fever to the eating of watercress. A copy of this
report was sent to this Council, with the request that we would support the suggestion that the
London County Council should make an extended enquiry on the supply of watercress of the
metropolis. This suggestion was supported by this Council.
As far as this district is concerned no cases have been traced to this source.
Continued Fever.
1 case was reported under this heading and the patient died. As she was not removed
to hospital, and there was no post-mortem, it is impossible to say precisely what the fever was.
It is probable it was a case of enteric, in which some of the usual symptoms were absent. As
far as preventive measures were concerned it was treated as enteric.
Puerperal Fever.
4 cases of puerperal fever were notified in 1904, and 2of these died. This is a considerable
diminution on 1903, in which there were 9 notifications and 4 deaths. Only one of these
cases was in connection with Guy's Hospital.
Measles.
As stated in last report the London County Council applied the sections of the Public
Health Act dealing with infectious disease, to measles, with the exception of those dealing with
notification and removal to hospital.
Taking advantage of this we have endeavoured to control the disease by disinfecting in
every case which came to our knowledge and excluding contacts for a period of three weeks and
until disinfection is completed.
The plan was not fully adopted in the early months of the year, but as the numbers of
cases and deaths began to increase, an effort was made to have measures against the
disease thorough and systematic.
The following is the first report on the subject presented to the Public Health Committee
on May 9th :—
" When reports of measles are received from the head masters of board schools,
my custom is to send on a notice to the master of the house similar to that which is
sent in cases of dangerous infectious diseases under the Public Health (London) Act,
1891, and also a postcard to be signed by the medical attendant and the master of the
house, when, in the opinion of the former, the patient is well and the house ready for
disinfection.
" I have written to several schools requesting them not to receive these children
back until they produce certificates that their houses have been disinfected.
" I am informed however, by the district Inspectors, that the School Board visitor
in connection with Alexis Street, Farncombe Street, and Keeton's Road Schools, has
been urging the parents to send the "contacts" back to school when he thinks it is
time for them to return, which is a fortnight from the beginning of the illness, and
telling them not to mind the question of disinfection.
" In this respect he would seem to be acting in conformity with the regulations of
the late School Board for London, in which it is stated that " children suffering from
measles must be excluded for at least one month. Children coming from houses where
measles exists, but who themselves are not suffering from the disease, must be
excluded from school for two weeks."
" This regulation was framed before the London County Council made the Order
extending certain sections of the Public Health (London) Act, 1891, relating to
infectious diseases, to measles. I do not see the use of enforcing these sections,
especially as regards disinfection, if children are allowed to go backward and forward
to school while a member of the family is lying ill with measles.
" This disease being so infectious and prevalent at certain times of the year no
doubt interferes greatly with school attendance.