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The number of deaths for 1918,1917, 1916, and 1916 were 9, 16, 12 and 24
respectively, and the case mortality 89, 76, 60, and 55 per cent. respectively
(some of the deaths were "inward transfers," not affecting the mortality
amongst notified cases).
The case that recovered lost one eye in the illness.
One case took its onset in January, 2 in February, 2 in March, 2 in May,
and 2 in June.
The duration of illness in the 8 fatal cases was as follows: —Under 1 day,
1 day, 2 days, 4 days, 8 days, about 3 weeks, 50 days, and 58 days.
Five of the cases were in males (4 fatftl), and 4 in females (all fatal).
One of the cases was under 1 year of age (fatal), two between 1 and 2 (one
fatal) one between 3 and 4, four between 8 and 15, and one l(i (all fatal).
In all the cases the meningococsus was identified; in 5 cases (2 culturally)
during life, and in the other 4 postmortem (one culturally). In two of the
cases the meningitis appeared postmortem to be confined to the spinal cord.
No connection between the cases and no source of infection was traced, and
in no instance was there more than one case in a house. The first six cases
were all in the more southern part of the borough, and the last three cases all
in the more northern part, but the cases were geographically well scattered
one from the other. All the patients were of the working class.
One case was treated in a Metropolitan Asylums Board hospital, 5 in
general hospi als and 3 at home.
ENCEPHALITIS LETHARGICA.
During 1918 cases of an obscure disease, with cerebral symptoms of a
lethargic nature and other characteristic signs, were described in various parts
of the country. It was at first suggested that they were of a similar nature
to the rare cases of food poisoning known under the name of Botulism, but
the disease was finally regarded as a definite clinical entity, to which was
given the name of epidemic lethargic encephalitis. It was not made notifiable
until January 1st, 1919, but during 1918 five St. Pan eras cases, which were
probably instances of the disease, and took their onset in February, March,
April, and May (2), were reported to the Medical Officer of Health.
MEASLES AND GERMAN MEASLES.
All cases of these diseases 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 constituting
a new outbreak.
Subject to correction for diagnosis in certain instances, 2,144 civil cases of
measles, and 311 of german measles were notified or otherwise discovered in
1918. This represents an incidence rate of 12.2 per 1,000 civil population for
measles and 1.7 for german measles.
75 deaths from measles were registered during the year, equal to a deathrate
of 0.43 per 1,000 civil population, and a case mortality rate of 3.5 per cent.
amongst notified cases. There were no deaths from german measles.