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inmates of asylums and in one the infection was conveyed from an existing
case. The death rate at all ages in London was 0.11 per 1,000 living;
17 deaths occurred in Westminster giving a rate 0.12.
In 1925, 17 cases of this disease—11 males and 6 females, were notified—
five cases eventually proving to be para typhoid. Four cases proved fatal.
Two cases of persons who have since recovered and two fatal cases could
be traced to the eating of shellfish. Of the remaining 13 cases, 12 contracted
the disease whilst on holiday abroad, or before coming to this
country, and one was a nurse who had been assisting at an abdominal
operation on a woman who was subsequently found to be suffering from
typhoid. In the cases where the consumption of shellfish was alleged to
be the cause of the disease, every enquiry was made to discover its source
of origin.
The case rate of the disease for England and Wales was 0.07 per
1,000 living and for Westminster, 0.12. The death-rate for England and
Wales was 0.01, for London 0.01, and for Westminster 0.02.
Measles.—The year 1925 was not a 'measles' year. The disease
assumes epidemic form every second year, and attacks large numbers of
children who escaped the infection at the previous outbreak in addition
to susceptible infants who have arrived at the age at which they seem to
become vulnerable to attack.
The following table shows the number of cases notified by head
teachers of schools, the Metropolitan Asylums Board, Hospitals and
private practitioners during the last five years:—
1921
1922
1923
1924
1925
26 591 131 852 117
All cases of measles do not come to our knowledge, but the above
figures give a fair idea of the proportion of cases from year to year. In
towns and cities, the attack rate is higher in the third, fourth and fifth
years of life, and these years are mostly covered by the information
forwarded by the school authorities. During the years 1916-1919,
measles was a notifiable disease and figures could be calculated with a
greater degree of accuracy, but after four years' experience the
Regulations were revoked by a Rescission Order made by the Ministry of
Health, as from 31st December, 1919; it was concluded that compulsory
notification was not the best method of solving the problem.
The majority of these cases must be treated at home, but many cases
occur where it is absolutely necessary that hospital assistance should be
sought, owing to the severity of the case, the bad home surroundings, or
the inability to isolate the patient from the other members of the family