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Of the cases notified, two were due to contact with patients suffering from typhoid fever and
two were due to infection acquired beyond the Borough. Three cases were attributed to the consumption
of oysters and four to mussels or other kinds of shell fish. In three houses where typhoid
fever occurred the drains were found to be defective.
Early in the year the Local Government Board undertook an investigation into the protracted
infectivity displayed by certain persons after an attack of typhoid fever. In Kensington two
patients whose tissues were known still to contain typhoid bacilli were discharged to their homes
after a prolonged period of detention in hospital. In each case bacteriological examinations were
made once a month for 6 months, but no typhoid bacilli were found. Recent researches in the
Indian Army and elsewhere have shown that although a small number of outbreaks of typhoid have
been proved to have been due to the protracted infectivity of typhoid convalescents, such
examples of protracted infection are in all probability extremely rare.
PUERPERAL FEVER.
Seven cases of puerperal fever were notified during the year, and of these four proved fatal.
The number of deaths from puerperal fever in the years 1901 to 1905 averaged between three and
four. Of the 3,000 births occurring every year a certain number are attended by complications
which necessitate instrumental delivery or other operations involving an added risk of infection,
whilst others occur in homes which are the reverse of cleanly . When the varied circumstances of
normal and abnormal labours are taken into account, the proportion of four fatal cases of puerperal
fever to 3,381 births in the present year must be considered as not far from representing the
proportion of unavoidable accident.
CEREBRO- SPINAL FEVER.
Four cases of cerebro-spinal fever, resulting in two deaths, occurred during the year. In the
four families attacked eight adults and 13 children were exposed to contact with infected persons
without acquiring the disease, and in no family did more than one case occur. The disease
followed on an attack of measles in a child aged 14 months, and one child aged three months was
suffering from a nasal discharge when the first symptoms of cerebro-spinal meningitis appeared.
Infectious Diseases not Notifiable.—Under this heading are included Measles, Whooping
Cough and Influenza, intensely infectious diseases, and Epidemic Diarrhoea, a disease the infectious
nature of which cannot be said to have been fully established. They are responsible for a very
much larger number of deaths than the notifiable diseases, as the following figures show.
Number of Deaths.
Notifiable Infectious Diseases 53
Non-notifiable Infectious Diseases 223
Notification without skilled medical supervision at home or in hospital would probably do but
little to lessen the prevalence and mortality from these diseases, but treatment in hospital either
with or without notification could hardly fail to diminish the mortality from Measles and Whooping
Cough in young children. At the present time children suffering from the worst forms of Measles
and Whooping Cough are rigidly excluded from hospital and left to their fate in surroundings which
often preclude the possibility of any treatment worthy of the name.
MEASLES.
The deaths from Measles numbered 58, and of these 57 occurred in children under five years
of age. All cases of Measles in children attending the elementary schools are notified by the Head
Teachers and visited by the Lady Sanitary Inspectors. During the year 480 cases were notified ;
62 additional cases were found in the homes visited, the total number of cases coming to the notice
of the Public Health Department being 542. Out of this number only 139 had received medical
advice before they were visited by the inspectors. A leaflet is left with the mother of each family
attacked calling attention to the serious nature of the disease and insisting on precautions being
taken to prevent the spread of infection. The largest number of cases occurred in the Wornington
Road School, where 108 children were attacked.