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39
always much more trying to children who have any
tendency to suffer from lung troubles than are the
months at the end of the year, and that the large
majority of these measles deaths resulted from
bronchial-pneumonia. Everything possible was done
to provide suitable treatment for these cases.
In my Annual Report for last year I detailed all
the methods used and the results, and it is unnecessary
to repeat this. I should mention, however, that the
Council in February appointed a temporary health
visitor for the purpose of visiting all the cases of measles
over the age of five years, those under that age being
dealt with by the permanent health visitors. Mrs.
Davies, the woman sanitary inspector, also gave considerable
help in visiting the cases of measles among
older children.
Encephalitis Lethargica.—As stated earlier in this
Report there were 21 cases of this disease, which is
commonly known as "sleepy sickness," notified during
1924. This is quite a considerable outbreak and is the
largest number which has ever been notified in any
one year in Fulham. The cases were scattered throughout
the Borough, and in only one case was one able to
trace with any reasonable certainty direct infection
from one case to another. It would appear that either
the infectivity in these cases is very low or else that
the population as a whole has a considerable resistance
to the infection. The disease is one which demands
the greatest respect not only because of the serious
nature of the acute stage, which probably has a case
mortality of anything between 30 and 50 per cent.,
depending on the nature of the outbreak, but also
because it is becoming more and more evident that
the sufferer from this disease is not rid of his troubles
when he has recovered from the acute stage, but that
he may be left with various forms of mental disturbance,
some being so bad as to alter the whole character of
the patient. Many cases have come to light during
the year in which children have developed bad and
even criminal habits apparently as a result of an attack
of this disease. Towards the end of the year I instituted