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19
The percentage of cases of school age (3 to 13 years) of the total number
notified in the Borough was 58, as against 69 in 1913. The month of
greatest prevalence was July (11 cases), and the month of least prevalence
August (2 cases). Taking the year as a whole, diphtheria was but little
prevalent at any time; and there was no special incidence on any school
in the Borough. The type of the disease was of average severity, the casemortality,
or percentage of deaths to cases being 10.5 per cent.
The average duration of stay in hospital of 50 cases, of which the
records are to hand was 49.9 days, as against 52 in 1913. Eight cases
admitted to M.A.B. hospitals were subsequently certified by the Medical
Superintendents of the hospitals not to be suffering from diphtheria or any
other notifiable disease. The average duration of stay in hospital of 6 of
these cases was 20.7 days. There were 2 "return" cases of diphtheria
in 1914, the intervals elapsing between the return home of the infecting
case and the onset of illness in the "return" case being respectively 9 days
and 11 days.
During the year medical practitioners sent 115 throat swabbings to
the Lister Institute for bacterioscopic diagnosis, as compared with 134 in
1913. Three were sent by myself from this department. The entire cost
was defrayed by the Borough Council. Of the total diphtheria swabs 71,
or 62 per cent. were sent by the medical staff of the Victoria Hospital for
children, in respect of Chelsea children. Of the total of 115 swabs, 22, or
19.1 per cent., afforded positive evidence of the presence of the specific KlebsLœtt'ler
bacillus, and 93, or 80.9 per cent., gave negative evidence. In 1913
the positives were 17.2 per cent., and the negatives 82.8 per cent. The
presence of Hoffmann's pseudo-diphtheria bacillus was recorded on 7
occasions in the negative samples.
Antitoxin was ordered for one case of diphtheria during the year by
the medical practitioner in attendance prior to the removal of the child to
hospital, the charge for the serum being borne by the Borough Council.
During the year 93 per cent. of the diphtheria cases notified were
removed to hospital, the corresponding figure for 1913 being 81 per cent.
Enteric Fever.—The number of cases of enteric fever notified in Chelsea
in 1914 was 23, as against only 7 in 1913, the case-rate being 3.4 per 10,000
of the population, as against 1.05 in 1913. Three cases were notified in the
first quarter of the year, 2 in the second quarter, 7 in the third quarter, and
11 in the fourth quarter.
Of the 23 cases notified, 6 were soldier patients at No. 2 General Military
Hospital, St. Mark's College. Five of these men had returned from the
British Expeditionary Force, and one was a Territorial quartered at Harpenden.
There was also one case of a Territorial quartered at the Duke
of York's Headquarters. Of the remaining 16 cases, two were patients
at a Nursing Home in Chelsea, and resided ordinarily in Boroughs outside
Chelsea.
Of the remaining 14 cases, in two the diagnosis of enteric fever was
not confirmed at the hospitals to which the patients were removed. In two
cases the patients were infected prior to arrival in Chelsea, one case being
infected at St. Buryan, Cornwall, and the other in Canada. In two other