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The above is a full list of the cases of this disease notified in
Bermondsey during 1915. As explained in previous reports there
are two forms in this disease. One is the sporadic, which is never
absent altogether from the district and is known as Post-Basic
Meningitis, and the other is the epidemic form or true cerebro-spinal
meningitis. The above cases, no doubt, belong to both forms and
it is probable that the majoity of the children are cases of postbasic
meningitis.
In London these two diseases are looked upon by the medical
authorities as one and the same, but in Belfast, where they have
had epidemics in recent years on a considerable scale, I am informed
by Dr. A. Gardner Robb, the medical superintendent of the Purdysburn
Fever Hospital, Belfast, that he considers them from a clinical
point of view as separate diseases. In this he is supported by Dr.
T. Houston, from the bacteriological standpoint, but the opinion
here expressed is not universally accepted. lam inclined to agree
with Dr. Robb, but from a practical point of view it does not matter
very much about drawing a distinction since the cases of post-basic
meningitis are very few and it only means a little extra disinfection
and examination of contacts, and it is just possible that if these
cases were excluded that genuine cases of cerebro-spinal meningitis
might be overlooked.
The last column of the table refers to military associations and
this was inserted in deference to the view that the disease was
imported here by the Canadians who in turn got it from American
sources. Only very few cases show any real connection with the
military, but one must remember that if you investigate almost
any disease from the same point of view you will get just about as
much connection with the military as in these cases, because the
inhabitants of many of the London boroughs have got many relatives
and friends serving at the front. The mortality, shown by
above table, is very high, namely 62 per cent., but many of the
cases were untreated by serum since death occurred very quickly
before anything could be done.
Were it possible to have all cases treated early by Flexner's
serum the mortality would not be more than about 12 to 15 per cent.