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18
ENTERIC FEVER.
The secondary cases (25) last year formed 12'8 per cent, of the total, as compared with 17.8
per cent, in 1910 and 9'5 in 1909. The comparatively high proportion of such eases last year
was due to the houses (and families) with 4 and 5 cases which would heavily weight a year
with so small a total of cases. From the houses (families) with two cases, both eases were
reported on the same day four times, and in four other instances the second case was due to
discharge of the previous patient. In the remaining six instances the intervals between the
first and second cases were 1 day, 3, 4 (twice), 12, and 45 days. From each of the houses with
three cases two cases were reported together. In one instance an interval of 20 days elapsed
between the onsets of the first and the remaining two cases, and in the other the second and
third cases were not reported, although their illnesses antedated that of the first by some days,
until after the first—a diagnosis not being arrived at until after consultation with the Medical
Officer of Health. The cases from the house with four infections were reported on the same
day, and the intervals between the cases (onsets) in the house with five cases were 2 (twice),
4, and 5 days. Except in the houses with return cases, direct personal contact with the primary
case was the cause of the secondary cases in all but one instance, in which the interval (45 days)
appeared to point to some other channel of infection.
Of the 226 reported cases, 218 were removed to hospital. The proportion of cases removed
to all cases was 964 per cent., an increase of 34 above the average for the preceding five years.
(Table 13.) From three Wards all the reported cases were removed to hospital, the smallest
proportion of the removed being noted in Westbourne Ward (85'7 per cent.). There was no
death among the eight cases kept at home, and only four (one an " error") among those
removed to hospital. The three fatal cases of scarlet fever were equal to a fatality of 1.5 per
cent, of all correctly diagnosed cases, the average for 1906-10 being 2.3. (Table 14.) The
fatality among the patients treated in hospital last year was 1.6, as compared with 2'4 for the
preceding five years. The deaths occurred among patients removed from Queen's Park (1
death) and Church (2 deaths) Wards.
The mortality from this disease last year was at the rate of 0.02 per 1,000 persons, the
lowest recorded since 1891, and probably the lowest on record. The rates recorded in each of
the six past years were:—
1906. 1907. 1908. 1909. 1910. 1911.
Deaths 18 13 15 14 7 3
Mortality 0.12 0.09 0.10 0.09 0.04 0.02
The rates recorded last year in the circumjacent districts are shown in Table 10. Lower rates
(0.01) were recorded in Westminster and Kensington. In Hampstead there was no death from
this cause.
ENTERIC FEVER.
(Including Continued Fever.)
Thirty-seven (37) cases of enteric fever were reported last year, and one of continued,
making a total of 38, or 4 more than the average (34) for the years 1906-10. The numbers of
cases reported in the individual Wards (totals for each year) during the past six years are given
in Table 7. The numbers recorded quarter by quarter have been too small to allow of satisfactory
averages being determined. A comparison of the annual averages for the Wards is
given below:—
Queen's Harrow Maida Lancaster Gate, Hyde
Park. Road. Vale. Westbourne. Church. West. East. Park.
Cases, 1911 2 9 9 2 7 3 3 3
Averages, 1906-10 3 7 5 3 9 2 1 4
The 38 " reported " cases were equal to a morbidity of 0.26 per 1,000 persons, 0 02 in excess of