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Prompt measures were adopted to bring its existence, and the
precautions to be taken to prevent the spread of the disease, to
the notice of the inhabitants of Camberwell.
Posters were displayed throughout the Borough, leaflets distributed,
and through the courtesy of the management of the
various cinemas in the Borough a slide was shown at every performance
for some days.
Although the death returns do not provide reliable information
as to the extent of the spread of this disease, yet they are a
good index of the severity of an outbreak.
Influenza and influenzal pneumonia were responsible for 103
deaths, of which 84 were certified as due to influenza.
Acute Rheumatism and Heart Disease.
In recent years acute rheumatism has received great attention,
and there is a growing concensus of opinion as to the
necessity of putting into force measures which might prevent the
chance of an attack and thus diminish the possibility of grave
sequelæ.
It is a well-known fact that carditis is frequently associated
with an initial attack of rheumatic fever. Approximately 40 per
cent, of the total deaths annually ascribed to heart disease are
considered to be rheumatic in origin.
In Camberwell 537 deaths were attributed to heart disease
in 1927, and of these 214 therefore can be said to have been due
to rheumatic fever.
While no age is exempt, there is a special liability to an
attack between the ages of 2 and 5 years, particularly in children
of school age. Between the ages of 2 and 5 years there is a gap
in the continuity of medical supervision owing to mothers not
taking advantage of the medical inspection afforded at Infant
Welfare Centres.
Rheumatism does not always take the form of an acute
illness. It frequently commences insidiously with no active
symptoms, but an occasional sore throat and vague pains.
It is essential to catch the rheumatic child before he is in
any sense a cardiac case, and for this purpose the Infant Welfare
Centres and the School Medical Service are in the best position
to render assistance. This cannot be effected without the cooperation
of parents, school teachers, and health visitors and for
this purpose instruction in the possible signs and symptoms
leading to a suspicion of the minor manifestations of rheumatic
infection in childhood is essential so as to encourage parents to
have their children medically examined. Growing pains, recurrent
sore throat or a pallor appearance should arouse a suspicion
of a potential rheumatic child, and by advice an attack, which
might lead to permanent damage to the heart, may be prevented