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8
SCARLET FEVER.
sex age group mortality was that for females aged 0.5 years, at which ages the mean for 1910.12 was
0.22 per 1,000, and in 1920.22 1.63—an increase of 641 per cent.
During 1910.12 the mean mortalities observed in the individual Wards varied from zero (Hyde
Park) to 0.10 (Queen's Park) and in the period 1920.22 from 0.01 (Maida Vale) to 0.29 (Harrow Road).
The mortality in the second period was lower in Maida Vale (by 75 per cent.), and in Lancaster Gate,
East (by 57 per cent.), but higher in all the others. Excluding Hyde Park, where the mortality was
zero during 1910.12 and 0.08 during 1920.22, the greatest increase in mortality occurred in Harrow
Road (383 per cent.).
Of the 25 deaths recorded last year, 24 (96 per cent.) took place in institutions. For the years
1910.12 the percentage was 88.4, and for 1920.22 95.8. The percentage of institutional deaths of
males has been consistently above that of females.
Carrier Clinic.—Last year 12 persons (5 males and 7 females) were referred by the Department
to the Special Clinic at St. Mary's Hospital. One patient failed to return to the Clinic after the first
attendance, although the swab taken on that occasion proved to be positive. The treatment of
the other 11 patients extended over periods varying from 1 to 13 weeks. Since the Clinic was opened
in 1920, 41 patients have been treated, all of whom (with the exception mentioned above) have been
successfully treated.
SCARLET FEVER.
The prevalence of this disease declined from a maximum of 738 cases, in 1914, to a minimum of
124 cases, in 1917, and increased to a second maximum of 827 cases, in 1921. Last year's total (529
cases—males 243, females 286) suggests that a period of low prevalence may be expected. For the
years 1920.22 the annual average number of cases was 619 (males 275, females 344), and that during
1910.12, 252 (males 123, females 129). The morbidity rate (per 1,000 persons) was 3.64 last year as
compared with a mean rate of 4.28 for 1920-22 and one of 1.77 for 1910.12. The sex rates (per 1,000)
for the two periods were : 1910.12, males 2.04, females 1.56; 1920.22, males 4.55, females 4.10.
The increases in the rates for the second period (1920.22) were : Persons, 142 per cent.; males, 123,
and females 163.
Comparing the sex.age.group morbidity rates for 1920.22 with those for 1910.12, the following
increases are found : 0.5 years, males 18 per cent., females 139 ; 5.15, males 190, females 209 ; 15.25,
males 97, females 160 ; 25 and upwards, males 47, females 133. The seasonal distributions of the
disease in the two periods were not identical. The percentages of the annual mean total were in
1910.12: 1st quarter, 22 ; 2nd, 25 ; 3rd, 25 ; and 4th, 28 ; the corresponding proportions for 1920.22
being, 18, 19, 26 and 37. In the first six months of the years 1910.12 the percentage of cases reported
was 47, and in the second 53, whereas in 1920.22, the proportions were 37 and 63. In the second
period there was an increase of 93 . in the first half of the year, and 192 in the second.
The morbidity rates recorded in the Wards during 1910.12 varied from a maximum of 2.45 per
1,000 persons (Harrow Road) to a minimum of 0.37 in Lancaster Gate, East. During 1920.22 the
maximum rate was 6.59 (Harrow Road), and the minimum 1.54 (Lancaster Gate, West). The maximum
increase noted in the second triennium was 551 per cent. (Lancaster Gate, East), and the minimum
69 (Lancaster Gate, West).
Among the 529 notified cases there were 41 " errors," equal to 7.7 . of the notifications,
as compared with an average of 5.4 . during 1919.21. Removals to institutions during the
year numbered 517, or 97.7 . of all notified cases, as compared with 97.2 in 1921, and an average
of 95.2 during 1919.21. There were four deaths during the year among the patients notified,
all of the deaths taking place in institutions. Two of the deaths were not certified as due to scarlet
fever. After correcting for errors the fatality rate (per 100 verified cases) was 0.41 last year, as compared
with 0.12 in 1921, the rate for that year being the lowest on record. For the years 1920.22
the fatality rates* were : Persons 0.36 ; males 0.24, females 0.48, which, on comparison with the
rates for 1910.12 (persons 1.71 ; males 2.43, females 1.03) show falls of 79, 90 and 53 . respectively.
During 1910.12 no deaths from this disease were recorded in the two Lancaster Gate
Wards, and during 1920.22 in Maida Vale, Westbourne and the two Wards just mentioned.
The cases notified last year included 18 cases in which the disease appeared to have been contracted
in institutions, and the same number from patients recently discharged from hospital. In
14 instances the patients came into the Borough after contracting the disease. In 15 instances two
cases were reported simultaneously from the family, and in 2, 3. In the course of the year the disease
caused two cases in 58 families, in 9, 3, and two families had 4 and 5 cases each.
* Per 100 notified cases.