London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Paddington 1913
[Report of the Medical Officer of Health for Paddington, Metropolitan Borough of]
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38
SCARLET FEVER.
Scarlet Fever : Morbidity. Per 1,000 persons.
| Queen's Park. | Harrow Road. | Maida Vale. | Westbourne. | Church. | Lancaster Gate, | Hyde Park. | ||
|---|---|---|---|---|---|---|---|---|
| West. | East. | |||||||
| 1913 | 5.45 | 4.27 | 2.39 | 3.90 | 3.69 | 1.26 | 2.94 | 1.24 |
| 1912 | 2.94 | 1.63 | 1.70 | 1.92 | 2.85 | 1.19 | 0.50 | 1.10 |
The subsequent course of the disease in 26 cases (5.4 per cent. of the total) showed that the
diagnosis of the disease had been erroneous. In 1912 the proportion of errors was 4.4, the
average for the five years 1908-12 being 7.3. Of the residue (correct diagnosis," definite cases ")
—458 in number—10 (2.1 per cent.) were contracted in institutions, 22 (4.8 per cent.) were
" imported," and 41 (8.9 per cent.) were " return cases," i.e., followed at varying intervals the
return home of patients discharged from the fever hospitals. In 1912 the return cases constituted
G-3 per cent, of the " definite" cases.
The 484 notifications were received from 376 houses, 70 of which furnished two or more
certificates. The house distribution of notified cases during the past five years is given below.
Scarlet Fever. {Notifications.— Uncorrected.')
| 1913. | 1912. | 1911. | 1910. | 1909. | |
|---|---|---|---|---|---|
| Houses with 2 cases each | 47 | 32 | 16 | 23 | 62 |
| ,, 3 ,, | 16 | 8 | 3 | 9 | 26 |
| ,, 4 ,, | 5 | — | 2 | 3 | 3 |
| ,, 5 ,, | — | — | 1 | 1 | 1 |
| ,, 6 „ | 1 | — | — | — | — |
| ,, 7 ,, | — | — | 1 | — | — |
| „ 10 ,, | 1 | — | — | — | — |
There were 8 cases of erroneous diagnosis among the 178 cases reported from houses with
two or more notifications, and in 11 of the houses the patients were members of two families
residing in the same house. The distribution of multiple cases, after correcting for errors of
diagnosis, according to the number of cases per house and family, is given below.
Scarlet Fever. ( Cases.—Corrected.)
| 1913. | 1912 | 1911. | 1910. | 1909. | |
|---|---|---|---|---|---|
| 42 | 29 | 14 | 21 | 59 | |
| ,, 3 ,, | 16 | 8 | 2 | 7 | 22 |
| ,, 4 ,, | 4 | — | 1 | 2 | 3 |
| „ 5 „ | — | — | 1 | 1 | 1 |
| ,, 6 „ | 1 | — | — | — | — |
| ,, 10 ,, | 1 | — | — | — | — |
| 46 | 27 | 14 | 22 | 51 | |
| ,, 3 ,, | 12 | 8 | 2 | 6 | 14 |
| ,, 4 ,, | 6 | — | 1 | 1 | 4 |
| ,, 5 ,, | — | — | 1 | 1 | — |
| „ 8 „ | 1 | — | — | — | — |
The occurrence of return cases played an important part in producing multiple cases.
In the 64 houses with multiple cases (164 in all, 100 secondary) there were 36 return cases,
equal to 36 per cent. of the secondary cases. There were as many return cases in the 65
families with multiple cases (160 cases in all, 95 being secondary), so that the return cases
constituted 37.8 per cent. of the secondary cases. In 19 instances two cases were reported at the
same time from the same house or family, and in one instance each, three and four cases. From
one family four cases were notified at very short intervals, but three of the four were found to have
been erroneously diagnosed. Multiple cases were much more numerous in Queen's Park and