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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 fewer cases of this disease than in 1924;
76 of the 214 cases occurred in St. John's Ward and 52 in Victoria Ward.
.
The disease was mostly contracted by children between the ages of 5 and
15. No deaths occurred. There is little doubt that a number of mild
cases occur which are not detected. The number of cases equalled 1.5
per 1,000 of the total population. In England and Wales the rate was
2"36, but as the majority of the cases (84.5 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. Of the total cases 98.6 per cent. were moved to hospital.
There is now considerable evidence in support of the view that Scarlet
Fever is a streptococcal infection, but so far it has not been possible to
identify a particular strain of the organism as the causal factor. Varieties
of this type of germ have been found in various cases, different types
seeming to vary according to the virulence of the infection. A test for
immunity to Scarlet Fever based on a skin reaction, somewhat similar
to the Schick test in Diphtheria and named after its discoverers—the
two doctors Dick—is now being investigated in this country. A method
of immunization against Scarlet Fever has also been devised. Neither
the Dick test nor the method of immunization has been practised so far
in Westminster
Diphtheria.—A larger number of cases occurred than during any
other year of the five-year period. This was largely accounted for by
two definite outbreaks. There were 286 cases, of which 92 occurred in
St. John's Ward and 127 in Victoria Ward. There were 17 deaths (9
males, 8 females), all in patients under 17 years of age. The first outbreak
began in November, 1924, in connection with a residential school in
St. John's Ward and the cases continued to- occur until the end of
February, 1925. There was one death in this outbreak, which involved
21 cases. Although 21 cases were notified, only 13 were considered to
be genuine sufferers from clinical diphtheria. The remaining eight were
found to show the presence of diphtheria germs in their throats. The
difficulty in dealing with carriers is shown by the fact that one scholar
gave negative results in December, positive at the end of the same month,
and was returned from hospital on 10th January as having been found
"not to be suffering from diphtheria"; on 19th January was again found
positive on swabbing, and removed to hospital. On 17th February, this