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17
Enteric Fever.—Twenty.nine cases of this disease were notified, 24 being removed to hospital.
The cases notified in the three preceding years were 22, 18 and 12. There were three deaths from
this cause against 3, 2 and 2 in the preceding years.
Twenty.one of the 29 cases were notified from the southern division of the Borough. This
heavier incidence in South Kensington is not usual with other infectious diseases, and it is probably
accounted for by the facts that water supplies and sanitary arrangements in London generally are
very good and that most persons contracting typhoid fever are infected outside the Metropolis. It
will be admitted that the residents in the southern portion of the Borough leave the London area
more frequently than those in the north, and, consequently, are more exposed to infection by reason
of the fact that many outside London districts do not enjoy the same sanitary efficiency.
In two cases there was evidence that the disease had been contracted on the Continent and in
a number of the others the patients had paid visits to country places just prior to the date of
attack.
Eight of the cases were notified as paratyphoid fever.
Puerperal Fever.—Five cases of this disease were notified in 1924, this being the smallest
number of cases since the year 1918. A number of women were sent into St. Mary Abbot's
Hospital immediately following an increase of temperature shortly after confinement and they
received prompt surgical treatment with the result that signs and symptoms abated and satisfactory
recoveries were secured. It is possible that some of these may have become definite cases of
puerperal fever in the absence of this treatment. Arrangements for the early admission to St. Mary
Abbot's Hospital of suspicious cases of this disease were discussed fully in my report for 1922 and
are referred to in this report in the section on Maternal Mortality.
Of the five definite cases notified, two were removed to St. Mary Abbot's Hospital, two to the
Metropolitan Asylums Board Hospitals, and one occurred in Queen Charlotte's Hospital, the
patient having entered that institution for her confinement. There was one death at St. Mary
Abbot's Hospital, one at Guy's Hospital and one in the home of the patient.
Encephalitis Lethargica.—This disease, commonly known as "sleepy sickness," was
prevalent throughout the country during the year, the number of cases notified in England and
Wales being 5,063, in London 620, and in Kensington 21. The number of Kensington cases
notified was the largest in any one year since notification was introduced in 1918. The following
table gives the sex, age, date of notification and result in the 21 cases notified during the year,
and shows that the disease in Kensington attacked males and females nearly equally, that it
attacked persons of practically all ages in life up to 51 years and that it cropped up in every
season of the year.
Sex. Age. Date of Notification. Result.
1 Female 9 7th February Recovered
2 „ 45 21st March Died
3 Male 2 5th April „
4 „ 13½ 23rd April Recovered
5 Female 27 1st May „
6 Male 33 5th May „
7 „ 19 6th May „
8 „ 12 9th May „
9 Female 22 15th May „
10 Male 31 16th May „
11 Female 3 20th May Died
12 „ 39 24th May „
13 „ 37 5th June Recovered
14 Male 5 6th June Died
15 „ 10 13th June Recovered
16 Female 5 16th June „
17 „ 51 1st July „
18 „ 44 14th July „
19 „ 17 26th September „
20 „ 21 5th December „
21 „ 50 18th December „
The disease during the year did not seem to be of such a severe type as was the case four and
five years ago, there being 5 deaths in the 21 cases giving a case mortality rate of 23.8 per cent.
This figure compares favourably with the figures of 40 and 50 per cent. which were common
several years ago.
There is good reason to believe that encephalitis lethargica is infectious and, therefore, the
disease has been made notifiable: but the degree of infectivity must be very slight, and other
occupants of a house in which a case has occured, or is being treated, may be assured that very
little risk is run by living in the same dwelling. At the same time it is desirable that association
with an infected person should be limited to what is necessary for proper care and nursing, and the
patient should be well isolated in a separate room.