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DIPHTHERIA.
For a number of years past diphtheria has been a black spot
upon our otherwise fairly clean bill of health. The accompanying
chart shows that the number of cases notified actually reached the
very high figure of 1,100 in 1922, and although the figure for
1928 is much lower, viz.:- 603, this cannot be regarded as a
satisfactory state of affairs. The number of cases returned as not
suffering from diphtheria was 51.
For the last six years of the decade, 1917—1926, Bermondsey
has suffered proportionately more heavily than any other London
Borough in respect of incidence and mortality from this disease
The average number of notifications has been 509 and the
average number of deaths 36. It is a little difficult to suggest an
explanation for these figures, and a little dangerous, since so
many explanations of similar phenomena have subsequently
proved to be wrong. The prevailing conditions of overcrowding
leap to the mind as a possible explanation, and I do not think
there is much doubt that these conditions do materially influence
the figures and tend to the spread of the disease. Another factor
is probably lack of knowledge resulting in infection of a second
child before the original case is removed to hospital. Possibly also
the infection is spread by carriers though the number of carriers
known to us is not very large. It is a curious and interesting
fact that the attack rate is higher in the "model dwellings" of
the Borough than it is in the "condemned areas." No doubt the
problem is an interesting one from the statistician's point of
view; but the one fact which seems to emerge from the figures is
that the disease is very prevalent in the Borough and that the
population as a whole shows a high degree of susceptibility.
Any means of combating the disease which offers the least
hope of success should be adopted and it is hoped that the means
provided by the Schick Test and Schick Immunization will soon
be available.