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The average duration of stay in hospital of 64 cases, of which the
records are to hand, was 58 days, as against 59 in 1911. Ten 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 1911 being 5. The average duration of the stay in hospital of
these 10 cases was 27 days, as against 19 in 1911.
During the year medical practitioners sent 160 throat swabbings to
the Lister Institute for bacterioscopic diagnosis, as compared with 105 in
1911. Five were sent by myself from this department. The entire cost
was defrayed by the Borough Council. Of the total swabs, 121, or 76 per
cent., were sent by the medical staff of the Victoria Hospital in respect of
Chelsea children. Of the total of 160 swabbings, 44, or 27.5 per cent.,
afforded positive evidence of the presence of the specific diphtheria
bacillus, and 116, or 72.5 per cent., gave negative evidence. These proportions
are nearly similar with those of previous years. Nine of the
negative swabbings showed the presence of Hoffman's pseudo.diphtheria
bacillus.
No applications were made during the year by medical practitioners
for anti.toxin, or for repayments for the supply of anti.toxin by chemists
in the Borough for the use of the poorer class of patients prior to removal
to the fever hospitals.
There was no special school incidence of diphtheria in 1912 in
respect of any of the schools in the Borough. In July, the children
attending a class at Ashburnham School were swabbed by the L.C.C.
school medical officer, as a child attending this class had been at school
with a sore throat, and subsequently developed paralysis of the soft
palate, pointing to the disease having been diphtheria. Only one of the
children who had been swabbed gave a positive reaction for the diphtheria
bacillus. Several other children were absent from school at the time, but
this was on account of mumps. The child that gave a positive reaction
was again swabbed two days later, the reaction being a negative one.
Three other diphtheria "carrier'' cases, amongst children, were
brought to light in the course of the year, but, so far as known, there was
no spread of infection from any of them.
Enteric Fever.—The number of cases of enteric fever notified in
Chelsea was 10, as against 7 in 1911, the case.rate being 1.5 per 10,000 of
population. Pour cases were notified in the first quarter of the year, 2 in
the second, one in the third, and 3 in the fourth quarter. The cases were
equally divided between North and South Chelsea.
Of the 10 eases notified, two were mistaken diagnoses. In one case
the Widal reaction proved negative on the 10th day of illness, this being
probably a case of septic poisoning. In the other case a diagnosis of
pneumonia was eventually made.
Of the remaining 8 cases, in three the infection was contracted
outside the Borough—one at Bamsgate (probably from eating infected
mussels); one at Six Mile Bottom, Cambridgeshire ; and the third case in
Kensington, the patient being a nurse at the Children's Hospital there.