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Report of Medical Officer of Health.] 15
The rates given in Table 10 do not show a reduction equal to that exhibited by the numbers
already dealt with, as the mean taken as a basis of comparison is that for the years 1895-99, during'
which there had been a less prevalence than in the years 1890-94. In the former period 1,257 cases
in all were recorded, in the latter, 1,262, while the mean estimated populations were 120,118 and
125,937 respectively. Bearing this in mind, the comparison of the rates for 1900 to the mean
rates cannot, expect perhaps as regards St. John, males, be regarded otherwise than as satisfactory.
The cases as recorded require to be corrected for errors of diagnosis, &c., although this has not
been considered in the foregoing paragraphs owing to the lack of information as regards the earlier
years. Last year the official inquiries enable the reported cases to be grouped thus:—
St. Mary. St. John.
Imported cases, primary 6 5
,, „ secondary 3 -
Return cases, primary 1 1
,, ,, secondary — —
Errors of diagnosis 12 5
Remaining cases, primary* 92 11
„ „ secondary 17 1
In 1899, 7 cases out of 203 (3.4 per cent.) were found to be erroneously diagnosed, as compared
with 17 out of 154 (11.0 per cent.) during the past year. Part of the apparent increase in
the percentage of error was probably due to an extended use of the bacteriological test—in some
cases not resorted to until after notification—but more so to the increased number of the certificates
forwarded by the Medical Superintendents of the Metropolitan Asylums Board. Even now it is
highly probable that the complete measure of error has not been obtained. From the very short
periods of isolation imposed in many cases, and the very slight nature of attacks observed in others,
it appears probable that, however much the naked-eye signs may simulate diphtheria, the cases are
not such in fact, i.e., are not due to infection by the bacillus diphtheria'. No doubt many of these
cases are infectious, and should be isolated, but it seems desirable that they should not be confounded
with diphtheria.
With regard to "imported cases," it should be observed that actual contact with diphtheria
patients is rarely demonstrated, but the inquiries go to prove that the patient either came from
some outside district at so recent a date as to raise a presumption that he (or she) was infected at
the date of arrival in the Parish, or that there had been illness in the house whence the patient came.
In 1899, 154 primary cases were due to infection apparently contracted in the Parish, being
75 per cent. of all the cases. Last year there were 103 such cases out of a total of 154, equal to
66.8 per cent. The secondary cases arising from these cases constituted 8.3 per cent. and 11.6 of
all cases respectively.
In the Reports for 1898 and 1899 attention was specially called to certain streets in the
northern section of the Parish from which an unduly large proportion of cases was reported. The
figures for last year are set out below in comparison with those of the two preceding years:—
1898.
1899.
1900.
Cases.
Houses.
Cases.
Houses.
Cases.
Houses.
Ashmore Road 11 10 11 10 4 4
Bravington Road 22 15 13 12 10 8
Chippenham Road 6 5 3 3 1 1
Fernhead Road 8 4 4 1 1
Kilburn Park Road 16 14 13 12 3 2
Portnall Road 9 9 18 14 8 4
Saltram Crescent 5 4 8 8 6 6
Shirland Road 11 10 10 8 4 3
Walterton Road 4 3 5 3 2 2
92 75 85 74 39 31
These streets contain approximately 1,700 houses.
* Including 1 case in which the disease was contracted in hospital.