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Previous to the introduction of the antitoxin method of treatment,
the rate was 22 per cent., but it cannot be too strongly impressed that
to be of use it must be used very early in the disease. The rate would
be lowered still more if antitoxin was more extensively employed by
general practitioners, as it is they who see the cases in the earliest,
stages. The mildness of many of the cases may have conduced to the
higher mortality this year through the nature of the malady not being
recognised in the early stages.
In one instance four cases occurred in one house (infected from a
baby who died unnotified); in one instance three cases occurred, and in
ten instances two cases.
Two children were sent back to hospital after discharge:—
(1) P. P. admitted with scarlet fever 25th September, 1905, discharged
January 3rd. On January 5th the diphtheria bacilluswas
found, and she was re-admitted, but the Metropolitan
Asylums Board Bacteriologist was unable to find it after four
cultures. She was therefore discharged again on January 12th.
(2) S. M. notified with diphtheria 28th January, discharged
19th February; discovered to have rhinitis, culture taken and
bacillus reported present. Re-admitted to hospital and kept
till 8th June.
Typhoid Fever.—Since the connection of this disease with certain
articles of food liable to be contaminated with infected sewage was
recognised, a decided improvement in the number of cases has occurred,
especially at sea-side towns. Consequently, persons returning home
from a stay at such places do not come back infected with typhoid
fever so frequently as formerly. Still a considerable proportion of the
cases notified in Westminster have contracted the disease elsewhere
frequently abroad, and a certain number of such cases may be expected
annually.
Forty-seven notifications were received in 1906, but seven persons were
eventually stated not to be suffering from this disease. The cases were
spread over all Wards as shown in Table XIV. Four deaths occurred.
Thirty-two of the notified persons were removed to hospital. Examination
for the presence of the Widal re-action was made, at the Council's
expense, in sixteen instances; in five it was present, in nine absent, and
in two it was doubtful, but both of these were notified; they proved
eventually not to be cases of typhoid fever. No history of the source
of infection was made out in twenty of the cases; in eighteen the
patients were ill on arrival in Westminster; three cases were attributed
to infected shell-fish, three to contact with other cases, and several to
drinking polluted water (Paris, Naples, New York, &c.).