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prevalent in the Kilburn area, and a number of deaths occurred.
The outbreak in the district was sudden and was of unusual virulence,
with an unusually high case mortality (at one time 50 per cent.) The
majority of children who died were found early and removed promptly
and were put upon the danger list at the Metropolitan Asylums Board's
Hospitals immediately upon removal. All our fatal cases received large
doses of anti-toxin serum, but the majority were regarded as hopeless
by the Hospital Authorities immediately they were seen. Everything
that could be thought of was done to check the outbreak which slowly
subsided, but spread just as widely over the West End Ward ; in
that district, however, the cases were of a much less severe type, and
the mortality there much lower.
At my suggestion the County Medical Officer of Health and
School Medical Officer caused periodical examinations to be made of
scholars attending certain schools in the infected areas around Netherwood
Street and Broomsleigh Street, and lists of the results were sent to
me, while the Head Teachers continued to notify me, as usual, of all
children absent or excluded from school on account of illness. These
children were "followed up" by the Health Visitors and Sanitary
Officers, and wherever possible the parents were persuaded to place
them under medical supervision.
In the course of combating the outbreak, difficulty was experienced
in dealing with the disease through the fact that in many cases the
parents were too poor to pay for the services of a doctor, and "suspects"
and "contacts" and cases bacteriological only in nature were found to
be without medical attendance and treatment.
I brought the matter before the Sanitary Authority who approved
of my suggestion that I should be authorised to provide a temporary
supply of medicine and medical assistance at the cost of the Borough
Council for the poorer inhabitants of the Borough. Under this scheme,
where a family had a regular medical attendant, but were in the present
instance unable to pay for his services, such doctor was asked by me to
examine the "suspects" and "contacts," &c., to swab where necessary
and to certify the cases discovered. He was also asked to give such
subsequent treatment (including the injection of anti-toxin supplied free
by the Borough Council) as he deemed to be necessary.
Arrangements were also made with certain medical practitioners
for their services to be called in at the expense of the Council in cases
of "suspects," &c., where the family had no regular medical attendant.
The milk supply of the district was considered as a possible source
of the outbreak, but a bacteriological examination failed to reveal any
evidence in favour of this.