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32
These figures do not include vaccinations and re-vaccinations done
by private practitioners. No vaccination was done by the Medical
Officer of Health under the Public Health (Small-pox Protection Regulations,
1917).
Scarlet Fever.- There were more cases of this disease than in 1923,
most of them being in the last four months ; 109 of the 237 cases occurred
in St. John's Ward and 54 in Victoria Ward. Three deaths resulted,
1 at age 4 and 2 between 5 and 10 years of age, all girls, giving a mortality
rate of 1.26 per cent, of the known cases. There is little doubt that
a number of mild cases occur which are not detected. The number
of cases equalled 1.6 per 1,000 of the total population, in England and
Wales the rate was 2.16, but as the majority of the cases (80 per cent,
in Westminster) occur in children and the proportion of children is lower
in Westminster than in the country as a whole, there is probably little
difference in the attack rate.
The proportion of children under 15 and others over that age in the
cases notified in 1901-5 were 76 and 24 respectively per 100 cases, in
the last 5 years the proportion is 80 and 20, so that fewer cases occur in
persons over 15 than formerly.
Attack rate.
1901-5.
1906-10.
1911-15.
1916-20.
1921-24.
Ages 0 to 15 years per 1,000
living at this age 9.0 12.6 14.1 9.3 13.3
Mortality per 100 cases at
0 to 15 years 3.25 2.82 1.7 1.1 0.8
This Table shows that while there is no diminution in the amount of
Scarlet Fever, yet the number of deaths has decreased to a marked extent;
that whereas in 1901-5 in every 1,000 cases, there were 32 deaths, now only
8 occur. This improvement had been going on in the 30 years before 1901,
the death-rate per 1,000 of the whole population of the country having
decreased from 0.97 in 1861.70 to 0.16 in 1891-1900; for last year it
was 0.02. Part of this great reduction may be due to the diagnosis
being better than it was in the middle of last century, part to the decrease
in the number of children but the general opinion is that Scarlet Fever
is a much milder complaint than it used to be.