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18
Small Pox.
Small Pox has again been conspicuous by its absence
in this district; only thirty-two cases have been
notified in the whole of the Metropolis during the year.
The question of Vaccination has been prominently brought
forward by the passing of the Vaccination Act of 1898. This
Act will be a huge experiment. It provides for the exemption
from vaccination of any child whose parents have a conscientious
objection to Vaccination. A more retrograde measure in the
cause of scentific teaching and research was never passed; it
remains to be seen what will be the outcome of
the next five years, as the Act is limited to that time. It is a
notorious fact that we have at the present day some thousands
of children in this district whose parents have evaded having
their children vaccinated.
Diphtheria.
Unfortunately this disease tends to steadily increase. Although
in our district there has been a sensible decrease during
the year, in various parts of the country diphtheria has been a
source of much concern to Sanitary Authorities, particularly in
London. A great responsibility rests with the sanitary advisers to
leave no stone unturned to check such increase, and with such an
object in view—to make use of the more recently proved
methods, bacteriological or otherwise. Reports upon the
continual use of Antitoxin in various parts of the
world are in the main favourable. The number of
cases notified in this district during the year was 294,
as against 445 in 1897—a considerable decrease—the
mortality being 14.1 per cent. There was, and always has
been, a marked diminution of this disease during that part of
the summer when the schools are closed, tending to shew that
school attendance has a marked influence as to its spread. We
take all the precautions we are able to prevent its spread, and
with that in view I have suggested that the children from any
infectious house should not be allowed to return to school until
one month after the case is removed to the Hospital, or at least
fourteen days after the patient has recovered if treated at home.
I am quite convinced that many children convey infection to
school if sufficient interval is not allowed to elapse between the
notification and school attendance.