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15-20 years, 6; over 20 years, 1. The ages of the fatal cases were:—
l9/l2, 2, 3, 3, 3, 4, 6, 6 and 10 years. Fourteen cases occurred in August,
12 in September and 5 in October, the onset of the last case being about
the 9th October.
In one family living in a house in Blantyre-street, where 4 children
were attacked, 3 died, and inquests were held on two of these fatal cases.
At the inquests it was stated that there was superficial ulceration of the
mucous membrane of the colon (lower bowel) from the ileo-cœcal valve
to the rectum in these cases, and that a streptococcus had been isolated,
which was regarded as the causative organism. Subsequent research,
however, carried out on behalf of the Local Government Board, showed
that the bacillus of dysentery (Shiga's bacillus) was present in a number of
the cases, and there can be but little doubt that the outbreak was one
of Dysentery.
The distribution of the cases occurring in August and September
in a very circumscribed locality in a poor neighbourhood is suggestive of
infection by contact, the children meeting and playing together in the
streets, and also possibly of fly infection by food. There was no evidence
pointing to an infection of any special food, such as milk, meat, fish, bread,
sugar, or ice-cream; and a sample of water taken at the Blantyre-street
house, where the fatal cases occurred on which inquests were held, was
found on analysis to be quite pure both bacteriologically and chemically.
Having regard to the number of soldiers who have been discharged
from the Army, who have had dysentery on foreign service, inquiries
were made as to any possible connection of this outbreak with the military
forces. One of the cases was a discharged soldier, but he was not attacked
until the 3rd week of August. It seems likely that the house in Davisplace,
World's End passage, which gave the first case in the outbreak
was visited by soldiers, but no actual evidence was obtainable.
Influenza caused 23 deaths in 1917, as against 24 in 1916.
The number of deaths from respiratory diseases was 172 in 1917, as
against 195 in 1916.
The deaths from pulmonary tuberculosis in 1917 numbered 79 (48 males
and 31 females). Other tubercular diseases caused 24 deaths, as against
12 in 1916, 17 being from tuberculous meningitis. Of the pulmonary
tuberculosis cases ending fatally, 28 per cent. died in the Chelsea Infirmary,
and 40.5 per cent. in other public institutions; that is to say, 68.5 per
cent, died away from their homes. In 1916 the corresponding figure was
61.5 per cent.
During the year, 161 new cases of pulmonary tuberculosis were
notified, as against 167 in 1916, 92 being males and 69 females. Fiftyfive
specimens of sputum were sent by medical practitioners to the Lister
Institute for examination as against 61 in 1916. Of the 55 specimens
33 per cent. were positive for Tubercle Bacillus and 67 per cent. were
negative; the figures for 1916 being 26 per cent. positive and 74 per cent.
negative.
In 1917, 21 cases of pulmonary tuberculosis were discharged from
open-air sanatoria, in which they had received institutional treatment as