View report page

7
diphtheria.
On November 13th a Vaccination Station was opened in Woodfield Road, the Public Vaccinator
attending twice daily. The station was closed on December 14th. During that period upwards of
6,000 vaccinations and re.vaccinations were performed, in addition to the vaccination of infants,
which went on as usual. The majority of the Staff at the Town Hall were re.vaccinated.
By direction of the Public Health Committee letters calling attention to the threatening danger
of an epidemic were issued to firms employing large staffs, and to the Bayswater Chamber of Commerce.
The letter also appeared in the columns of the local papers.
A circular letter was sent to the medical practitioners practising within the Borough, informing
them of the arrangements made to provide vaccination, and of the facilities for consultation with the
Experts appointed by the County Council and with the Medical Officer of Health. Happily no case
of the disease occurred within the Borough, but the Medical Officer of Health was called in on several
occasions to assist in the diagnosis of doubtful cases. A few contacts with cases in other districts
were reported and followed up.
VI. SPECIAL DISEASES.
(See Tables III., IV., V., VI. and VII. Appendix.)
DIPHTHERIA.
(Including Membranous Croup.)
There has been a notable increase in the prevalence of this disease since 1920, but such increase
is not peculiar to the Borough. The cases reported last year (401) were 44 fewer than the total for
1921 and 66 below that for 1920. The annual average for the three years, 1920.22, was 437, as compared
with an average of 286 for the years 1913.15, a difference equal to 53 . of the average
for the earlier triennium.
During the years 1910.12 the notifications of this disease numbered (on an average) 177 a year
(males 76, females 101), and the morbidity rate was 1.24 per 1,000 persons—1.26 per 1,000 males
and 1.23 per 1,000 females. During 1920.22 the annual average of 437 cases comprised 181 among
males and 256 among females, the morbidity rates being 3.03 for persons, 2.99 for males and 3.05
for females. Roughly speaking, the numbers of cases in the second period were two and a half times
as numerous as in the first, while the morbidity rates showed increases of 144 . for persons,
137 for males and 148 for females.
The seasonal distribution of the cases reported during the past year was not quite normal, the
proportion of cases reported in the second and third quarters of the year being higher than is usual.
Last year 30 . of cases were reported during the first quarter, 25 during the second, and 23
during the third and 22 during the fourth. The averages for the quarters during the periods 1910.12
and 1920.22 were : 1st, 30 and 33; 2nd, 24 and 20; 3rd, 16 and 18; 4th, 29 and 29. The averages
for the quarters in the second period showed the following percentage increases, 146, 89, 77 and 125.
The sex-age group morbidity rates during the years 1920-22 show the following increases above
the corresponding rates for 1910-12 : 0.5 males, 147; females, 223; 5.15, males 164, females 149;
15.25, males 121, females 171 ; 25 and upwards, males 218, females 318. The increase in prevalence
among adults, especially females, is striking.
Of the 401 cases reported during the year, 204 were notified after bacteriological examination,
the results being "positive" in 195 instances and negative in the others. Thirty.seven (37) of the
notified cases were definitely recognised as cases of " bacteriological diphtheria."
In 57 instances the original diagnosis of diphtheria was proved to be erroneous, equal to 14.2
. of all notified cases, as compared with an average of 8.2 during 1917.21. The cases removed
to institutions numbered 387, equal to 96.5 . of the notifications, the average for 1917.21
being 91.8 per cent.
Among the notified cases there were 37 deaths, only one of which took place in the patient's home.
The 37 deaths included one occurring in 1923 and 12 deaths certified to have been due to diseases
other than diphtheria—the majority of such deaths, other than 4 fatal " errors," being those of
patients with bacteriological diphtheria. One death was transferred to the Borough without
notification, and one death of a patient notified in the Borough was transferred elsewhere. The total
fatality of the disease (. of verified cases) was 7.3, as compared with a mean rate (1917.21)
of 5.3.
The mortality rates for last year were : Persons, 0.17 : males 0.19 and females 0.29 per 1,000.
The rate for persons for the three years 1920.22 was 0.17, and that for the years 1910.12 0.06—showing
an increaseof 176 per cent. The rates for males were 1910.12, 0.05, 1920.22, 0.14—increase 180
per cent., and those for females 0.07 and 0.19—increase 171 per cent. The greatest increase in