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In 14 of the 20 cases the diagnosis was confirmed by identification of the
meningococcus (in six cases grown in pure culture) in the cerebrospinal fluid
(12) or exudation on brain and cord p.m. (2) and in 2 others the recognition
of the germ was doubtful.
Amongst the 12 fatal cases post-mortem examinations were made in 9 cases
and there is no record in one other. The 9 autopsies showed typical cerebrospinal
meningitis with exudation in 4 cases, oedema and softening of the brain
without exudation in 4 cases, and a doubtful result in one case.
Amongst the 8 cases who recovered, one was left quite blind, and one stone
deaf. In the other six cases the recovery was practically complete.
In only 3 of the 20 cases was any history of hsemorrhagic rash obtained;
one of these died and 2 recovered, one being left blind.
5 of the cases (3 fatal) were under one year of age, 7 (6 fatal) between one
and 5, 4 (2 fatal) between 5 and 15, and 4 (1 fatal) over 15.
There was not much tendency for the cases to group round foci. No source
was traced in any case, and there were no secondary cases in the affected
houses. The patients were all of the working class.
In addition to the above civilian cases, there was one case notified in the
person of a soldier, not a St. Pancras resident but billeted in the borough.
This case was fatal, had a hæmorrhagic rash and was confirmed
bacteriologically during life and on post-mortem examination.
These diseases were made compulsorily notifiable from January 1st, 1916,
by the Public Health (Measles and German Measles) Regulations, 1915.
Fairly reliable statistics as to the incidence of the diseases are therefore now
available. All cases are notifiable by parents and guardians, but only the first
case occurring in an outbreak in a household or institution is notifiable by
medical practitioners, an interval of two months since the last case c instituting
a new outbreak.
Subject to correction for diagnosis in certain instances, 1,855 civil cases of
measles and 381 of german measles were notified in the borough during 1916.
This represents an incidence rate of 9 4 per 1000 civil population for measles,
and 1.9 for german measles.
42 deaths from measles were registered during the year, equal to a deathrate
of 0'2 per 1000 civil population, and a case mortality rate of 2.3 per cent.
amongst the notified cases.
There were no deaths from german measles.
MEASLES AND GERMAN MEASLES.