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26
Scarlet Fever.—180 cases of this disease occurred in 1927—an increase
of 48 on the figures of 1926. The wards showing a slight increase are
those of St. John and Victoria—the former with 12 and the latter with
16 more cases. The disease was contracted mostly by children between
the ages of 3 and 15. There was one death. The case rate of this
disease per 1,000 of the population was 1.29, the rate for England and
Wales being 2.16. The death-rate for Westminster was 0.07 per 1,000,
and for England and Wales 0.. Of the total cases in Westminster
96 per cent.were moved to hospital.
Diphtheria.—185 cases of this disease occurred, showing a decrease
of 38 on the figures of 1926. Again the wards showing the decrease are
St. John and Victoria—the former with 12 fewer cases and the latter with
35. At no time was there any semblance of an outbreak during the year,
the closest co-operation having existed between the Council's staff and
that of the London County Council in the following up and swabbing of
contacts of cases already sent to hospital, or of children who were sent
home from school with sore throats. Most of the cases and deaths
occurred in children between the ages of 3 and 15. There were 9 deaths
(5 males and 4 females), giving a rate of 48.6er 1,000 cases. The
case rate of this disease for Westminster was 1.2 per 1,000 living, and
that of England and Wales 1.3. The death-rate for Westminster was
0.6, and for England and Wales 0.7.
All cases that are reported to have been excluded from school on
account of suspicious bacilli having been found in swabbings from their
nose and throat are visited by the Sanitary Inspectors, and the parents
advised to consult their doctor, but in cases where the family is numerous
and the income too slender to enable them to call in a medical practitioner,
they are visited by the Assistant Medical Officer of Health at their homes,
or advised to call at 1, Pimlico Road for swabbing.
Thus unsuspected carriers are discovered, often apparently robust in
health, but nevertheless a dangerous source of infection to their fellows.
Sixty-three diphtheria contacts in school children were swabbed by Dr.
Thomson during the year, of whom 3 proved positive. All of the latter
were removed to hospital for isolation and for such treatment as is necessary
to clear away the infection. It is important that virulence tests
should always be carried out on persistent carriers so that those carrying
virulent bacilli may be retained for special treatment, while the nonvirulent
carriers may safely be discharged to their homes.
The following report by Dr. Thomson indicates the progress of the
Schick wor since it was begun in the City in 1926. The number of cases