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II.—NOTIFICATION OF INFECTIOUS DISEASE.
In Table V. of Appendix will be found particulars of infectious
diseases notified during the year under report.
There has been a notable falling in these since last year.
During the War Bermondsey was particularly free from infectious
diseases of all sorts, but during the year 1920 we had a tremendous
epidemic of Scarlet Fever. In November, 1921, the cases
of diphtheria became more numerous than the cases of scarlet
fever, and they have remained so ever since. A fall in both these
diseases commenced in February, 1923, and has been maintained
up to the time of writing. It is very difficult to explain either
the prevalence of these diseases, or why the number of cases of
diphtheria (586) should be greater than the number of cases of
scarlet fever (323), but we know that all infectious diseases tend
to occur in periodical epidemics of longer or shorter intervals,
due partly to an accumulation of susceptible material, or from
unknown causes, such as the increase in the virulence of the
poison producing them. In other cases the explanation may be
found in an increase of decrease of household pests, such as lice
and fleas. Lice we know cause typhus fever, and Sir William
Hamer of the London County Council, thinks that the flea may
account for the prevalence of scarlet fever. If casual observations
have any value, the frequent one which I have heard during
the last year on the remarkable reduction in the number of fleas,
suggests a possible factor in the reduction of the prevalence of
scarlet fever.
The number of cases of infectious diseases notified, exclusive
of notifications of tuberculosis, which numbered 461, was 959
compared with 2,077 in 1922 and 2,045 in 1921.
The attack rate per thousand inhabitants was 7.88 against
17.15 in 1922.
48 cases were returned from hospital as not suffering from the
disease for which they were notified, but, if allowance is made
for mild unreported cases, the recorded notifications would, if
anything, understate the actual number of cases.