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21
DISEASES OF CHILDHOOD.
From what has been written in the preceding paragraph it is evident that rates of incidence calculated
on the populations at all ages fail to show adequately the real incidence of the disease. Unfortunately
no information is to hand as to the sex.age distributions of the populations of the Wards,
so that nothing beyond the all.age rates can be given. Last year the cases in Harrow Road Ward
numbered 836 and in Church Ward, 745, these two Wards furnishing not far short of half the cases
reported during the year. The rates of incidence (measles and german measles, persons, all ages)
were : Queen's Park, 20.1 ; Harrow Road, 30.3 ; Maida Vale, 16.7 ; Westbourne, 23.4 ; Church,
29.9; Lancaster Gate, West, 7.4 ; Lancaster Gate, East, 11.6 ; and Hyde Park, 18.1.
Last year 198 (6.1 per cent.) patients received treatment in institutions, the average for the
preceding quinquennium being 4.9 per cent. In 1915 and 1917—years of major epidemics—the
percentages removed to institutions were 2.1 and 3.4 respectively. In 1918 the proportion was 7.9
per cent., and in 1921 7.1.
In each of two institutions 18 cases occurred, and of the remaining 3,189 cases 59 . came
from houses having one case in each.
The deaths from measles during the year numbered 33, equal to a total fatality (all ages) of 1 . 0
per cent., the average fatality during 1917.21 having been 2.3 per cent. In 1915 the fatality was
2.7 per cent., and in 1917, 3.3. The fatality of cases in males (all ages) was 1 .2 . last year,
averaged 2.7 during 1917.21, and was 3.1 in 1915 and 3.9 in 1917. Among females the percentages
were: 1922, 0.9; 1917.21, 1.9; 1915, 2.3; and 1917, 2.8.
The fatality rates last year for the two sexes were at ages 0.5, 1.8 per cent., 5.15, 0.08 and 15 and
upwards, 0.6. At ages 0.1 and 1.2 the rate (combined sexes) was 3.7, at ages 2.3 and 3.4, 1.1 and
at 4.5, 1 .0.
During the months of January and July to December no deaths from this cause were recorded.
In February the fatality was at the rate of 0.4 per cent., in March, 0.3, in April, 1.1, in May, 2.3,
and in June, 0.8. During the months of March to May (both inclusive) there were 2,302 cases and
29 deaths, equal to a fatality of 1 . 2 per cent.
Of the 33 deaths 20 occurred in institutions (5 in hospitals of the Metropolitan Asylums Board
and 15 in Paddington Hospital). The fatality among the patients removed to institutions was at
the rate of 10.1 per cent., among those remaining at home 0.46.
During 1909.13 notification was not required, but every effort was made to discover cases ot
measles, and 4,740 cases were placed on record. If it be assumed that the error (deficiency) amounted
to one.third, the full total of cases during the three years would be 6,320. In that period 157
deaths were certified as due to the disease, equal to a fatality of 2.48 per cent. The estimated deficiency
is believed to err on the side of excess. During 1920.22, 5,118 cases were recorded with
63 deaths, a fatality of 1.19 per cent.—showing a fall of 56 per cent. The deaths during 1909.13
included one (of a female) at ages over 15, and those recorded during 1920.22, 2 (both females). Distributing
the remaining deaths into two groups, viz., 0.5 and 5.15, and calculating the mortality rates
per 1,000 of each sex enumerated at the Census of the central year of each period, the following results
are obtained: 0.5, males, 1909.13, 12.7; 1920.22, 6.3 (a reduction of 50.4 per cent.). Females,
1909.13, 11 .4 ; 1920.22, 4.9 (reduction 57.1 per cent.). At ages 5.15 the rates are : Males, 1909.13,
0.29; 1920.22, 0.20 (reduction 30.6). Females, 1909.13, 0.67; 1920.22, 0.09 (reduction 86.8
per cent.).
Whooping Cough.—This disease not being on the list of diseases to be notified, the Department
has to rely on reports of cases from the school teachers (" Form 84 "), and other sources. No effort
is spared to secure the fullest information. Last year 378 cases were placed on record in the Department,
188 cases in males and 190 in females. In 1921 the cases numbered 613, and in 1920, 355.
Of the total for last year 231 (males 111, females 120) were cases in children under 5 years of age,
143 (males 73, females 70) in children aged 5.15 years, and 3 (male 1, females 2) in persons aged 15
years and over. The 378 cases occurred in 220 houses, 117 of which had one case each. More than
half the cases (231) occurred in two Wards, viz., Westbourne, 106 cases, and Church, 125. There
were 55 cases in Harrow Road Ward and 39 in Queen's Park. The patients receiving institutional
treatment numbered 9 (2.3 . of the known cases). In 1921, 2.2 . of the known
cases received institutional treatment.
The deaths certified to have been due to whooping cough during the year numbered 11 (6 of males
and 5 of females), giving a fatality of 2.9 per cent., the rate in 1921 having been 3.4 and in 1920, 3.9.
The 5 deaths in institutions constituted 36.3 per cent. of all deaths from this cause, and represent
a fatality of 55.5 . of cases receiving institutional treatment.
The collection of statistics of this disease was commenced in 1903, so that data for twenty years
are now available. The average numbers of cases reported in the four quinquennial periods covered
by the twenty years are: 1903.07, 410 cases; 1908.12,451; 1913.17,486; and 1918.22, 439. That
of the last period showing an increase of 7 per cent. above that of the first—an increase due, probably,