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ophthalmia neonatorum. 9
Three of the cases reported during the year occurred in primiparœ, one in a woman pregnant
for the second time and the fifth in a woman pregnant for the third. One case (primipara, aged 24)
followed (so far as could be ascertained) a normal labour, one (primip., aged 27) after a breech presentation,
one (primip., aged 32) after instrumental delivery, one (3-parous) had some laceration and the
fifth (2-parous, aged 31) had a miscarriage (not free from suspicion of mechanical interference).
The fatal cases were the first and last mentioned. Three of the patients were removed to M.A.B.
Hospitals, one to the Paddington Hospital and one to a Nursing Home.
The 2 deaths recorded last year were equivalent to a fatality of 40 per cent. of cases, 15 per cent.
above the rates recorded in 1921 and 1922. The mean fatality during 1910-12 was 40.7 per cent.
and that during 1920-22, 28-7.
The annual average number of deaths in the quinquennium 1913-17 was 5, and that during
1918-22, 3.
Fatality of Childbearing.—To measure this, the deaths from the various "Accidents and
Diseases of Pregnancy and Parturition"—here referred to as "other causes"—have to be added
to those from puerperal fever. Last year, for the first time since 1901, when the Borough was constituted,
there was no death falling under this headiing, so that the total deaths were 2 (due to puerperal
fever). During 1913-17 the deaths of pregnant and parturient women averaged 10 a year, 5 from puerperal
fever and 5 from "other causes." During the years 1918-22, the deaths averaged 9 a year,
3 from puerperal fever and 6 from "other causes."
The 2 deaths recorded last year were equivalent to a fatality rate of 0.76 per 1,000 births (corrected
total), due to the fatality from puerperal fever. The mean rate for the years 1913-17 was 3.56 per
1,000 puerperal fever and "other causes" contributing equally. During 1918-22 the mean was 3.66
per 1,000, 1.34 per 1,000 being due to puerperal fever and 2.32 to "other causes."
OPHTHALMIA NEONATORUM.
The notified cases numbered 22 last year, as compared with 15 in 1922, and 34 in 1921. The
22 cases (equivalent to 8.3 per 1,000 births) comprised 12 in male infants (8.9 per 1,000) and 10
in female (7.7 per 1,000). Attacks in legitimate infants numbered 20, equal to 9.4 per 1,000 legitimate
births, and those in illegitimate infants, 2 (9.4 per 1,000). The incidence on males in the two categories
was practically equal but that on illegitimate females was 15.2 per 1,000—there was only one
case—as compared with 7.6 per 1,000 for legitimate females. No cases were reported from the two
Lancaster Gate Wards. In Hyde Park Ward the attack rate (2 cases only) was 11.8 per 1,000,
and that in Queen's Park Ward (3 cases) 12.2.
During the five years 1913-17, 151 cases were reported, giving a mean attack rate of 11.2 per
1,000 per annum. During 1918-22 130 cases were reported, the mean rate being 9.7. These figures
taken in conjunction with the general run of the annual numbers (Table 3) encourage a hope that
a diminution in prevalence has set in.
In addition to the 22 cases notified during the year, information was received from the County
Council of 6 cases of the disease in slight forms, such cases, although requiring supervision, were,
apparently not severe enough to be notified. In 1922 a similar number of such cases were reported
by the County Officials.
Eight of the notified cases were removed to hospital, 6 going to St. Margaret's (M.A.B.). Many
of the infants kept at home attended ophthalmic and other hospitals as out-patients. The District
Nurses visited 3 cases.
As regards the termination of the cases, one infant died in St. Margaret's a few days after admission
and one removed from the Borough before the termination of the attack. Of the remainder, in one
instance only was any injury of the eye reported, and that was said to be slight only. Histories
of venereal infection were obtained in 3 instances only.
SEPTIC DISEASES.
Erysipelas.—The cases notified numbered 54—23 in males and 31 in females, a proportion
agreeing with the sex-distribution of the estimated population. In 1922 the cases numbered 77.
During 1913-17, the annual average was 112, and that during 1918-22, 73, showing a reduction of
one-third. The attack rate last year was 0.37 per 1,000 persons, the rates for each of the sexes
being the same. In 1921 the rate was 0.57, and in 1922, 0.53.
Two of the cases notified during the year were marked errors, and in 3 instances the disease
was contracted in institutions. The site of the disease was returned as—Head, 37 cases; Lower
extremity, 11; Upper, 5; and Trunk, 1. A definite history of trauma (injury) was obtained in
9 instances only, but there is little doubt that that figure very inadequately represents the truth.