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The influence of school closure in August upon the prevalence of the
disease was well marked, only 3 cases being notified during the entire
month. In September there were only 4 cases, but the number rose to 15
in October, falling again to 8 in November and 5 in December.
Special school incidence was shown in respect of the Christchurch
Infants' School in October, 6 cases being notified amongst children
attending that school in the second week of the month. The action taken
in respect of these cases was effective in preventing any further extension
of the disease.
The average duration of stay in hospital of 64 cases, of which the
records are to hand, was 55 days, as against 53 in 1908. Six cases
admitted during the year to the M.A.B. hospitals were subsequently
certified by the Medical Superintendents of those institutions not to be
suffering from diphtheria or any other notifiable disease, the corresponding
number in 1908 being 9. The average duration of the stay in hospital of
these 6 cases was 17 days, as against 21 in 1908. Three cases of
diphtheria on discharge from M.A.B. hospitals were stated to be still
suffering from rhinorrhœa, but free from diphtheria bacilli.
During the year medical practitioners sent 93 throat swabbings to
the Lister Institute for bacterioscopic diagnosis, the cost being defrayed
by the Borough Council. Sixty-two of these swabs were sent by the
medical staff of the Victoria Hospital in respect of Chelsea children. Of
the total of 93 swabbings, 20, or 21.5 per cent., afforded positive evidence
of the presence of the specific diphtheria bacillus, and 73, or 78.5 per
cent., gave negative evidence. Nine of the "negative" swabbings
showed [the presence of Hoffman's pseudo-diphtheria bacillus, but none
of the " positive " swabbings contained this bacillus.
Enteric Fever.—The number of cases of enteric fever notified in
Chelsea in 1909 was 12, as against 17 in 1908, the case-rate being 1.6 per
10,000 of population. This is the lowest rate yet recorded. Four cases
were notified in the first quarter of the year, 5 in the second, 2 in the
third, and 1 in the fourth quarter. In North Chelsea 5 cases were
notified, and in South Chelsea 7 cases. Two cases ended fatally.
Of the 12 cases notified, one was stated by the Medical Superintendent
of the M.A.B. hospital to which the patient was removed, not to be
suffering from enteric fever or any other notifiable disease. This case
was kept in hospital for 18 days.
The average duration of stay in hospital of 5 cases, of which the
records are to hand, was 85 days, the corresponding figure for 1908 being
49 days.
Out of the 11 verified cases, in 3 the infection was in all probability
contracted outside the Borough of Chelsea. There would appear, therefore,
to have been only 8 cases in 1909, which can be regarded as having
contracted the disease in Chelsea, as against 12 in 1908, and 16 in 1907.
One blood specimen was sent during the year to the Lister Institute for
the Widal reaction, the result being negative.
During the year Dr. Theodore Thomson, on behalf of the Local
Government Board, introduced a scheme by which in cases of enteric
fever, where it is found necessary to discharge a patient from a M.A.B.