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34
Scarlet Fever.—241 cases of this disease occurred in 1.928— an
increase of 61 on the figures of 1927. The wards showing a slight increase
are those of St. John, Victoria, and St. Anne. The disease, which hitherto
was contracted mostly by children between the ages of 3 and 15 has,
during the past year claimed many cases among those of more advanced
years. 146 cases occurred in those between the ages of 3 and 15, and
76 cases between 15 and 45. There was one death. The case rate of
this disease per 1,000 of the population was 1.81, the rate for England
and Wales being 2.61. The death-rate for Westminster was 0.007 per
1,000, and for England and Wales 0.01. Of the total cases in Westminster
96 per cent, were moved to hospital.
I * !
Diphtheria.—233 cases of this disease occurred, showing an increase
of 45 on the figures of 1927. The wards showing a marked increase are
St. John and Victoria—the former with 21 more cases and the latter
with 11. 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, but there
was an increase in the number of cases in those of higher ages. There
were 13 deaths (10 males and 3 females), giving a rate of 55.7 per 1,000
cases, and of these deaths 7 occurred between the ages of 5 and 10 giving
a death rate for that period of 79.5 per 1,000 cases. The case rate of
this disease for Westminster was 1.75 per 1,000 living, and that of
England and Wales 1.55. The death.rate for Westminster was 0.10,
and for England and Wales 0.06.
All cases 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 Koad for swabbing.
Thus unsuspected carriers are discovered, often apparently robust in
health, but nevertheless a dangerous source of infection to their fellows.
Fifty.seven diphtheria contacts in school schildren were swabbed by
Dr. Thomson during the year. It is important that virulence tests