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which were of children over 1 but under 15. This is nearly
double the total for last year, when St. George's headed the list with
168; now it still retains its premier position, but with a credit of
285. But, notwitstanding the great increase in persons attacked,
there were only two more deaths, the case mortality rate being now
a little under 1 per cent. This progressive decrease in the fatality
seems to indicate that either a lessening of the virulence of the
organism or organisms concerned has taken place, or that a more
resistive population has come into being. That there has been a
change of type seems certain, for even more than last year did we
hear of instances chiefly, but not entirely, from the schools where
children had suffered from attacks of sore throat with or without a
slight eruption, and who on a chance and subsequent examination
by the school nurse were found to be peeling. At the end of July
a notification was received of scarlet fever in a boy of five. On
making enquiries at the home it was found that his sister, who had
been taken ill a month previously, was now peeling. But her illness
had been of so slight a character that she had been continuing her
work at a blouse and pinafore maker's, and the boy had also been
attending school up to the commencement of the school holidays.
This is only a rather marked example of many similar occurrences.
During the year we have continued to receive during the
sessions of the Elementary Schools lists of children who have
been excluded from school. Some of them, of course, are excluded
for reasons which do not concern us, but there remain
many others who are debarred from admission on account of their
presenting symptoms which are often associated with the notifiable
infectious diseases. In any doubtful instance the Sanitary Inspector
pays a visit to the house, and if he has any suspicion of infectious
disease he advises that a doctor should be called in.
In the great majority of cases there is no reason for advising
this course, for the reasons of exclusion given to the school
authorities are often not those given by the parents to the Inspector,
and the child is frequently stated to be quite well, and in some
instances is even found to have resumed attendance at school.
Indeed, the unreliability and the delay, which are no doubt
unavoidable, but which are ordinarily involved in our hearing of
such cases, render the information of little value.
There were 62 deaths from measles, compared with 79 in 1911
and 107 in 1910. Contrary to the usual experience, a not inconsiderable
number occurred among those who were over five years of
age. The policy of removing those suffering from this disease to
the Asylums Board hospitals has been continued, with the probable
saving of many children who would have died had they been kept
at home. About the beginning of November the pressure on the
hospitals became somewhat severe, and the Board then required us
to give certain particulars to them, which were designed to ensure
first of all the removal of those who would be most prejudiced by
being kept at home on account of poverty, or, on the other hand,
where the conditions favourable to infection would be most pro-