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5
In 1917, 56 cases of diphtheria were notified in Chelsea, as compared
with 109 in 1916. This disease caused 8 deaths in 1917, the case mortality
being 5.3 per cent., as compared with 14 per cent, in 1916; 86 per cent.
of the cases were removed to hospital. The percentage of cases of school
age (3 to 13 years) was 66, as against 71 in 1916. There was no special
incidence on any particular school, and practically no increased prevalence
in the autumn months.
During the year medical practitioners sent 70 throat swabbings to
the Lister Institute for bacterioscopic diagnosis, as compared with 108
in 1916. Of the 70 specimens, 40 or 57 per cent. were sent by the Victoria
Hospital in respect of Chelsea children. Of the total 70 specimens, 17,
or 24 per cent., afforded positive evidence of the diphtheria bacillus, and
53, or 76 per cent., were negative. In 1916 the positives were 20 per cent.
and the negatives 80 per cent.
The number of cases of enteric fever notified amongst the civil population
was 10, as against 8 in 1916. Of the 10 cases in one the diagnosis
was not confirmed at the M.A.B. hospital to which the patient was removed.
In 3 other cases the infection was due to the Paratyphoid (B.) organism
and not to the Bacillus Typhosus. In two other cases the patients were
infected prior to their arrival in Chelsea—1 at Reigate, and 1 in another
Metropolitan Borough. There were, therefore, only 4 cases of enteric
fever, out of the 10 notified, in which it seems probable that the infection
was contracted in the Borough. There were no deaths amongst these
4 cases. Five specimens of blood from suspected cases were sent to the
Lister Institute for the Widal reaction. One was positive, and 4 were
negative.
The deaths in Chelsea from diarrhoea and enteritis in 1917 were 35 in
number, as against 26 in 1916. Nineteen of the deaths were of infants
under 1 year, and 6 were between 1 and 2 years of age. Twenty deaths
occurred in the summer quarter of the year. The Health visitors paid
126 visits to homes in connection with cases of summer diarrhoea.
Outbreak of Dysentery.
From early in August, 1917, until mid-October, some 31 cases of this
disease occurred in Stanley Ward, and there were 9 deaths, the case
mortality being 29 per cent. The two earliest cases occurred in a house in
Davis-place, World's End-passage, and in a house at the South end of
Riley-street, close to Davis-place, in the first week of August. After the
lapse of a week there were 3 more cases in the same house in Riley-street,
followed after an interval of 5 or 6 days by other cases in two houses in
Blantyre-street. Until the end of September all the cases occurred in the
vicinity of the World's End, but later, 5 cases occurred in a house in the
western portion of Lots-road, and 2 cases in a house in Meek-street, which
are some distance from the World's End. In eight houses only one person
in a single family was attacked. In one house 2 families were attacked—
8 persons in one family and 2 in another. In four other houses single
families were attacked, the number of persons in each family affected being
5, 4, 2 and 2.
Of the 31 cases the ages were ascertained in 26, and were as
follows:—under 1 year, 2; 1-5 years, 9; 5-10 years, 4; 10-15 years, 4;