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44
primary case The primary case was reported to have a discharge from the nose
and on examination was diagnosed by me as still suffering from scarlet fever;
swabs taken from the patient's nose and throat gave evidence that he was also
a diphtheria "carrier." I notified the case and the boy was again removed to
hospital.
Return cases occur when patients are treated at home and in much the same
proportion
There were two deaths from scarlet fever.
17,225 cases of scarlet fever were notified in London with 299 deaths.
One patient notified in 1921 who returned home in December, 1921, and gave
rise to a "return" ease that year was kept under observation, owing to nasal
discharge. The chid was not fit for readmission to school until the middle of
June, 1922.
Puerperal Fever.
No case of puerperal fever was notified; but in the causes of deaths as
classified by the Registrar-General, one death is included as caused by puerperal
sepsis. This classification was made as a consequence of a further enquiry to
the certifying medical practitioner, who stated that when he attended the patient
she had just returned in a hopeless condition from hospital, where she had been
under treatment for five months. She was suffering from septic endometritis and
chronic heart disease and died in three weeks. The medical practitioner was
informed that endometritis was due to an incomplete abortion which had occurred
some time previous to her admission to hospital.
311 cases were notified in London, and gave rise to 122 deaths.
Enteric Fever.
Four cases were notified during the year.
265 cases were notified in London, with 44 deaths.
The first of the four notified cases was that of a female, ago 17, a visitor
at one of the hotels in the Borough, who was removed to a nursing home for
treatment. The diagnosis was confirmed by bacteriological examination of blood
and urine. The patient and her parents were visiting London from their home
in Caermarthenshire. It was ascertained that three or four weeks prior to the
onset of the illness the patient had partaken of cockles in connection with a village
fete. As a result of enquiries made by the Medical Officer of Health of the
County it was ascertained that two other members of the party were found to he
ill with abdominal symptoms but apparently neither of these were notified as
cases of typhoid fever although the County Medical Officer of Health expressed
the view that the history suggested that both patients suffered from paratyphoid
fever of one type or another.
The second case notified, eventually was found not to be a case of enteric
fever. He was a schoolboy aged 12 years. On post mortem examination the
disease was ascertained to be cerebro-spinal meningitis.