View report page

14
SCARLET FEVER
SCARLET FEVER.
Between 1901 and 1905 this disease decreased annually in the Borough, except for a slight
rise in 1903, the totals for each of the five years having been 503, 359, 414, 365, and 277
respectively. Last year the total was 715, showing an increase of 257 per cent. In the
Metropolis, on the other hand, there has been a progressive increase in prevalence since 1903,
when 12,545 cases were recorded, the figures for the past six years having been—1901, 18,386;
1902, 18,258 ; 1903, 12,545 ; 1904, 13,451 ; 1905, 19,469 ; and 1906, 20,326. Last year's total
for the Borough is the highest on record since 1896, when 909 cases were reported.
A reference to Table 7 will show that while the prevalence of scarlet fever was last year
greater in all the Districts mentioned, the morbidity rate of the Borough was the highest of
the series.
The local returns for the first quarter of the year were eminently satisfactory, only 48 cases
being reported, the lowest number for that quarter with the exception of the first quarter of
1890, the first year of notification, when the system was probably not so complete as it is at
the present time. The decennial (1896-1905) average for the quarter is 92, nearly double the
number recorded last year. About the middle of April (see Diagram facing page 4) the disease
began to be more prevalent, mainly in the northern half of the Borough. During the second
quarter 164 cases were notified, as compared with a decennial average of 93. Once only
has the total for that quarter been higher, namely, in 1893, when it reached 213. The rise in
prevalence continued during the third and fourth quarters, the total number of cases being
213 and 290 respectively. Higher totals were recorded in the third quarters of 1892 (222),
1893 (289) and 1896 (310) ; but the total for the fourth quarter of last year is the highest on
record, the nearest being that of 1896 (266). The largest number of cases reported in any
week during the past year was 46 (49th week ending December 1st).
Queen's Park, Harrow Road and Church Wards were the districts most affected
(Table 6), but the incidence of the disease did not follow the same course in all. Thus
Queen s Park Ward shows a decline during the third quarter (Table 12), Harrow Road a
progressive increase to the last quarter, and Church a maximum in the third quarter, followed
by a considerable reduction in the fourth. There was a decline in prevalence throughout the
year in Lancaster Gate, West, Ward, and only slight increases in the two other Wards of
South Paddington.
It is believed that some explanation for the undue prevalence in Queen's Park and
Harrow Road Wards, at least, is to be found in school attendance, which point will be dealt
with later in this report. This is confirmed by the number of attacks at school ages,
5-13 years. (Table 5.) At the same time the great diminution in the numbers of attacks
recorded during the past few years undoubtedly contributed to the spread of the disease after
it had gained a footing, bv reason of the large proportion of children being unprotected.*
There is further reason to believe that there were a considerable number of attacks of a
specially mild and often abnormal form of the disease, which either escaped observation and
medical attendance altogether, or misled the practitioners in attendance. These " missed
cases " are a fruitful source of infection owing to no precautions being observed. Certain of
such cases come to the knowledge of the Department during the year. In Church Ward
the large number reported during the third quarter of the year included an unusually large
proportion of the cases erroneously diagnosed.
* It has to be remembered that in 1904 and 1905 the morbidity rate for scarlet fever was higher in the
Metropolis as a whole than in the Borough.