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Fatal diarrhoea is seen to be a disease of infancy, increasing in prevalence in the late summer
and easy autumn; deaths from measles and whooping cough occur in early childhood; influenza
is chiefly fatal in old age and late middle life, the number of deaths showing a marked remission
in the summer months.
MEASLES.
The deaths from measles numbered 27 and with only one exception occurred in children
under 5 years of age.
In the first 9 months of the year after the serious outbreak of 1911, the deaths from Measles
remained well below the average number. In the last quarter of the year a noticeable rise in the
death-rate has since proved to have been the beginning of an extensive epidemic in the first
Quarter of 1913.
All cases of measles in children attending the elementary schools are notified by the head
teachers and visited by the lady sanitary inspectors. During the year 485 cases were notified;
144 additional cases were found in the homes visited, the total number of cases coming to the
notice of the Public Health Department being 629. Out of this number only 159 had received
medical advice before they were visited by the inspectors. A leaflet is left with the mother of
each family attacked calling attention to the serious nature of the disease and insisting on
precautions being taken to prevent the spread of infection. The largest number of cases occurred
in the Wornington Road School, where 75 children were attacked; Buckingham Terrace School
contributed the next largest number, notifying 51 cases of measles during the year.
The cases admitted to the hospitals of the Metropolitan Asylums Board numbered 140.
WHOOPING COUGH.
The deaths from whooping cough numbered 25; the number of cases brought to the notice
of the Public Health Department by the schools being 240. In the homes visited 64 additional
cases were discovered; the total number of cases dealt with by the Sanitary Inspectors being 304.
An advisory leaflet was left with the mother of each family visited. The largest number of cases
occurred in the Portobello Road School, where 20 children were attacked; the Wornington Road
School contributed the next largest number, notifying 11 cases of whooping cough during the year.
Of the cases visited only 54 had received medical treatment. The limitation of fatal whooping
cough to young children was shown by the fact that 22 out of 25 deaths, or 88 per cent. of the
total number registered during the year, occurred in children under the age of 5 years.
During the first 7 months of the year beds in the hospitals of the Metropolitan Asylums Board
for persons suffering from whooping cough were only available for pauper patients applying for
admission through the officers of the Poor Law Guardians. On August 9th, 1912, the Local
Government Board issued the Metropolitan Asylums (Whooping Cough) Order, 1912, which
authorises the admission to the hospitals of the Managers of the Metropolitan Asylums Board of nonpauper
patients with whooping cough on the recommendation of the Medical Officer of Health. The
following restrictions, which also apply to cases of measles, are imposed by the Order, namely:—
1. That the Managers shall not receive a non-pauper case, unless they have more accommodation
than is required tor pauper patients. 2. That the recommendation of the Medical Officer of Health
shall be accompanied by such information respecting the circumstances of the patient as the
Managers may require, and 3. That when it becomes necessary to determine the priority in which
patients shall be admitted, the Managers shall have regard to each patient's need of isolation in
the interests of the public health. Information is required by the Managers under the following
heads:—l. Number of children under 5 years of age in family who have not had the disease,
ii. Number of rooms occupied by patient's family, iii. Is the patient seriously ill? iv. Do you
consider the home conditions prejudicial to the patient's chances of recovery? The questions in
themselves are sufficient to indicate the circumstances under which the Medical Officer of Health
J5 now able to secure the removal of patients with whooping cough or measles to hospital.
During the year 82 cases of whooping cough were admitted to the hospitals of the Metropolitan
Asylums Board.