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a week or so after the removal or recovery of the case to the municipal
laboratory at the Town Hall for examination. If diphtheria
bacilli are found in the throats they are excluded from school for a
fortnight, and if then found to be free, are allowed to return to
school. The number of children thus examined in 1913 was 352,
belonging to 145 families. Out of this number 8 had diphtheria
bacilli in their throats or noses, 4 of whom developed the clinical
symptons of diphtheria, and were therefore notified.
Scarlet Fever.
The notifications of scarlet fever in 1913 were practically
double those for 1912. This result is not altogether unanticipated,
as reference to the report for 1912 will show. Scarlet fever like
other infections diseases has a tendency to rise and fall at intervals
of certain numbers of years and we are evidently on the upgrade
again. The causes of these prevalences are not fully known but an
increase of susceptible material among the population is probably
the most potent cause. Fortunately the type is very mild and
attended with a low death rate. This very mildness has no doubt
conduced to some extent to the prevalence since cases are very
liable to be overlooked.
There were 732 cases notified—503 for Bermondsey, 206 for
Rotherhithe, and 23 for St. Olave. This is an increase of 321 for
the Borough on the total for 1912. The distribution of the disease
in the various Wards, as shown in Table III. of Appendix, was
fairly uniform.
25 cases were returned from hospital as not suffering from scarlet
fever.
The accompanying chart shows the prevalence of the disease
in each of the 52 weeks under report. The average notifications
for the past ten years are shown in green.
There were 5 deaths, which gives a case mortality of 0.68 per
cent., against 1.9 per cent, in 1912. The disease, as in recent years
was of a mild type. The attack rate per thousand inhabitants
was 5.9, against 3.3 in 1912.
In 62 cases the source of infection was attributed as follow:—
Previous cases in house or family or neighbouring
houses 26
School infection 23
" Return " cases 13