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CEREBROSPINAL FEVER.
17
Twenty-six (26) patients were removed to hospital (Table 13), equal to 74.2 per cent.
(Table 14) of all the cases, as compared with an average of 70.2 per cent. for the
quinquennium. In 1906 the percentage was the same as last year. The fatality of the
disease among patients treated at home was 33.3 (30.0 in 1906) per cent. (Table 14) as
compared with a quinquennial average of 27.5, while among hospital patients the fatality
was only 9 per cent. (18.1 in 1906), the average being 12.6. These fatalities have been
calculated after making allowances for known errors of diagnosis. The advantage of
hospital treatment for the disease has been commented upon in previous reports.
The nett mortality was at the rate of 0.03 per 1,000 persons, or 0.02 below the
quinquennial mean rate (0.05). (Table 14.) The corrected mortality was also 0.03, 0.11
below the standard rate and 0.01 below the mean. (Table 15.) The mortality in the
Metropolis was 0.04, the same rate prevailing in Westminster. In the other districts, except
in Kensington, where it was equal, the rate was lower than the local rate.
CEREBROSPINAL FEVER.
In consequence of outbreaks of this disease in certain parts of the provinces an Order
was made by the London County Council in February of last year requiring the disease to be
notified. Notification was imposed by the first Order for six months, that period being extended
by a second Order, issued in the following August, to two years. It may be mentioned that cases
practically identical with "cerebrospinal fever" occur in London every winter, and are
generally diagnosed as "basic meningitis." In consequence such cases were required by the
second Order to be notified.
Prior to the making of the first Order certain cases were brought to the notice of the
Department which were suspiciously like attacks of cerebrospinal fever. In two instances
"gram negative" diplococci were obtained from the cerebrospinal fluid, but in neither case
did the cocci give the reactions peculiar to the meningococcus of Weischelbaum.
Up to the close of the year no notification of cerebrospinal fever had been received.
SEPTIC DISEASES.
These are for statistical purposes divided into two groups, viz., "puerperal fever" and
"other septic diseases" (including erysipelas, septicaemia, pyæmia, &c.). Of those diseases,
puerperal fever and erysipelas are scheduled for notification, nothing being known of the
others, except the numbers of deaths.
Puerperal Fever.—The reported cases of this disease fell from 12 in 1906 to 6 in 1907.
In 1905, 7 cases were reported, while the average for the five years 1902-06 was 9. Half the
cases of last year occurred in Queen's Park and Harrow Road Wards (Table 5), the numbers
recorded in 1907 being, however, well below the averages for those Wards (Table 12). Last
year's morbidity rate for the Borough (0.04) was 0.01 below the quinquennial mean (0.05).
In the circumjacent districts decreases in the rates were recorded in Kensington and Westminster,
an increase in Willesden alone (Table 7).
In as much as the frequency of pregnancy is declining, a better measurement of the prevalence
of puerperal fever is afforded by the percentage frequency with reference to
the births which take place during the year. The morbidity, per 100 births, during last year