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diphtheria. 19
SMALLPOX.
Neglecting the case erroneously diagnosed in 1911, there has been no notification of this
disease in the Borough since 1906. In the whole Metropolis 5 cases were reported last year, as
compared with 72 in 1911. In the Extra-Metropolitan parts of England and Wales 109 cases
were reported during the year, or 84 fewer than in the preceding year. (See Table 10, page 16.)
The cases dealt with at the Ports numbered 12, against 30 in 1911.* The disease appears to
have been generally low in prevalence during the past year, contrary to what might have been
expected with the occurrence of the two campaigns, viz., that in Tripoli and that in the Balkan
Peninsula.
Vaccination.—From the returns furnished annually by the Vaccination Officer, Table 14
(page 28) has been constructed. Compared with the preceding year, the proportion of children
fully accounted for—either by vaccination, death, or insusceptibility to vaccination—was practically
unchanged, while the number exempted by certificates during 1911 constituted 13 0 per of
the children born, or 0.8 per more than in 1910. The increasing neglect of vaccination was
somewhat fully dealt with in the Report for 1911 (pages 12 and 13).
DIPHTHERIA.
(Including Membranous Croup.)
Last year 288 cases were reported (see Table 6), viz., 244† of diphtheria and 4 of
membranous croup, or 80 in excess of the number reported in 1911. The morbidity rate (1.74
per 1,000 persons of all ages) was 0.57 above the rate for 1911 (117), and 0.67 above the mean
for 1907-11. In Hampstead alone was the rate recorded last year (1.88) in excess of that
recorded in the Borough. (See Table 7.)
It will be seen from Table 8 that the largest numbers of cases were reported from Harrow
Road (60 cases), Queen.s Park (53), Westbourne (18), and Church (43) Wards, and from Table 9
that the disease was most prevalent in the first and second quarters of the year. The latter
table also shows that in comparison with the averages for 1907-11 the incidence of the cases was
far heavier in Queen.s Park Ward (last year.s record, 53 cases, being nearly three times the
average, 19). The morbidity rates in the Wards were as follow:—

The morbidity rates recorded last year were below the corresponding rates for 1911 in
Maida Vale, Lancaster Gate, East and West, Wards, but that of Lancaster Gate, East, Ward was
the only one below the average for 1907-11.
The 248 cases reported included 15 in which the original diagnosis was not confirmed in
hospital. Such cases, for brevity.s sake termed "errors," were equal to 6.0 per of the total
cases, the lowest proportion noted since 1902, when records of these cases were first kept. In
1911 the "errors" formed 11.3 per of the reported cases, the average for the five years
1907.11 being 129.
* The figures given above were obtained by a weekly compilation of the returns received from the Local
Government Board. According to the Annual Return of the " Incidence of Notifiable Diseases" during 1912,
published since writing the above paragraph, there were 4 cases of smallpox in London, and 107 in the rest of
England and Wales, 72 of the latter cases occurring in towns connected with ports. The Returns contain an
account of the prevalence of the disease in other countries.
† The cases of clinical diphtheria numbered 205 last year, the reported total being swollen by the large number
of "carrier" cases reported as a result of a systematic search in connection with certain of the public elementary
schools and the Children.s Hospital.