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50
EPIDEMIC CEREBROSPINAL
MENINGITIS.
On March 12th, 1907, epidemic cerebro-spinal meningitis
(cerebrospinal fever) became a compulsorily notifiable infectious
disease throughout the administrative County of
London, in accordance with the provisions of Section 56 of
the Public Health (London) Act, 1891. This disease had
taken on epidemic proportions in Belfast and Glasgow, and it
was thought advisable to make it notifiable throughout
London, so as to prevent it being introduced and spreading
there. Up to the end of 1907, a total of 153 cases were notified
in London (13 in Lambeth Borough), whilst during 1908
a total of 85 cases have been notified in London (14* in
Lambeth Borough). Of the 14 cases notified in Lambeth
during 1908, 3 occurred in Waterloo, 3 in Lambeth Church,
7 in Kennington and 1 in Brixton, Registration SubDistricts.
Of the 14 cases notified, 10 died.
The disease is "an acute, epidemic disease," characterised
by profound disturbance of the central nervous system, indicated
by the onset chiefly of shivering, intense headache or
vertigo, or both, and persistent vomiting; subsequently by
delirium, often violent, alternating with somnolent, or a state
of apathy or stupor; an acutely painful condition with
spasm—sometimes tetanoid—of certain groups of muscles,
especially the posterior muscles of the neck, occasioning retraction
of the head; and an increased sensitiveness of the
surface of the body. Throughout the disease there is marked
depression of the vital powers, not unfrequently collapse; and
in its course an eruption of vesicles, petechiæ, or purpuric
spots, or mottling of the skin, is apt to occur. If the disease
tends to recovery, the symptoms gradually subside without
any critical phenomena, and convalescence is protracted; if to
*Of the 14 notified cases, 13 were removed to Hospital, and of
these one was found at Hospital not to be suffering from that
disease.