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In the 6 cases classified as "return" cases the source of infection was some other
member of the family or occupant of the same house who had returned from hospital after an attack
of scarlet fever within a fortnight previous to the second case occurring. In this case the source of
infection in the second case is presumed to he the child recently returned from hospital. The following
statement on the subject is reprinted from my Annual Report for 1907:—"A good deal of attention
has been given to these so-called 'return' cases on the part of the laity, and also by medical
authorities, the former generally being inclined to attribute it to premature discharge from the
infectious disease hospital. As stated, however, in previous reports, facts do not support this view,
because in the first place the cases are very few compared with the number discharged, and in the
second case it is sometimes those children who are detained months over the usual time and that
cannot be considered to have been prematurely discharged who produce the disease.
"The micro-organism which produces scarlet fever has yet to be discovered, and the probability
is that when this is made it will be found it behaves in a somewhat similar manner to diphtheria, and
will be found to exist in the noses and throats of the patients who either have not got the disease at
all, or who have recovered from an attack some considerable time previously. Those patients who
have suffered from complications leading to pathological discharges from nose, throat and ears are
more liable to spread the disease than simple, uncomplicated cases."
Measles.
The number of deaths for 1910 was 143, against 196 in 1909 and 105 in 1908.
The annexed table gives the number of notifications received from schools, the number
of "contacts" excluded. In the first quarter there were only 3 deaths, in the second 29, in the
third 42, and in the fourth 69.
As remarked in my previous report, there is no doubt that the infants' departments of the
schools are very largely responsible for the spread of this disease, but the London County Council's
regulations, of which the following is a copy, are strictly carried out:—
(1) Senior Departments—
(a) If a child has had measles it need not be excluded from attendance at school.
(b) If a child has not had measles it should be excluded from attendance at
school for a period of 14 days from the date of the occurrence of the
first case.
(2) Infants' Departments-
All children should be excluded from attendance at school for a period of 14
days from the date of the occurrence of the last case.
Enteric Fever.
37 eases of enteric fever were notified, being 21 for Bermondsey, 13 for Rotherhithe, and
3 for St. Olave. 1 case was returned as not suffering, making an actual total of 36. The total
number of cases notified in the previous year was 29.
They may all be classified as sporadic, i.e., isolated cases, so that there was nothing at all in
the nature of an outbreak.
In 8 cases the source of infection was attributed as follows:—
From previous cases 5
From eating mussels 2
From eating oysters 1
Puerperal Fever.
6 cases of puerperal fever were notified. There were 3 deaths.
Membranous Croup.
No patients were notified as suffering from membranous croup.
Phthisis.
During the year 1910, 289 fresh cases of phthisis were notified. Of these 106 were notified
voluntarily, compared with 102 in 1909, and 183 under the Poor Law Order, compared with 346 in
the previous year. In the appended table will be seen particulars of cases notified in the various
wards:—
W *
G
C £
W °
M
Bermondsey 'Wards. R °^™s THE St - Olave Wards.
1 2 j 3 I 4 ° 6 1 2 3 John Olive Thomas
Voluntary Notifications 106 12 . 17 19 21 6 4 8 7 3 j 6 1 2
Poor Law Notifications 183 33 I 27 17 5 10 20 27 13 6 J 9 15 1
! 289 j 45 44 I 36 26" 16 24 | 35 20 9 15 i 16 . 3
Re-notifications ...1
(Changes of Address, 210 46 45 16 8 7 12 34 6 9 12 10 5
&e.) J
Rooms disinfected ... 618 [128 85 83 76 ' 43 56 56 39 32 ' 11 4 5