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in 14 others the homes were only fairly clean. In four cases there was evidence
of exposure; one by immersion in the sea; two by getting very wet during work,
and one by getting wet whilst under the influence of alcohol.
In one case a brother of the patient had died from "(1) septic sore leg and
(2) pneumonia" six weeks before the development of the disease in the notified
case.
With the exception of notifications from hotels and boarding houses, it
would seem that notification has been confined to the poorer part of the community.
Influenza.
There were only 8 deaths from influenza in comparison with 11 in 1920, 46
in 1919 and 138 in 1918.
A minor wave of influenza passed over the country during the latter part
of 1921 and the early part of the present year.
The disease is not notifiable and the extent of its prevalence has therefore
to be estimated on the number of deaths recorded. This number showed signs
of increase in the early part of December, 1921 and continued to increase until
the middle of January, 1922, from which date the outbreak subsided.
Having regard to the population of Holborn in comparison with the whole of
London the deaths recorded in the Borough are a fraction less than the numerical
proportion. Moreover, as we have a large amount of common lodging house
accommodation and our population probably includes more than the normal
proportion of old people, it would appear that the incidence of the disease in the
Borough was somewhat less severe than in London as a whole.
Steps taken to deal with the outbreak included a supply of anti-influenza
vaccine ; the exhibition of warning posters ; the distribution of a special leaflet ;
the maintenance of efficient and uninterrupted ventilation in theatres and
cinemas, churches and other places of assembly; and a communication to proprietors
of restaurants respecting the necessity for thoroughly cleansing all glasses,
drinking utensils, etc.
Anthrax.
No case of anthrax was notified during the year.
At the end of January a communication was received from the Ministry of
Health, drawing attention to cases of anthrax in man, in which infection had
been traced to the use of shaving brushes imported from Japan before the prohibition
of importation under the Order in Council, dated February 9th, 1920,
made in pursuance of the Anthrax Prevention Act, 1919. In consequence of