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43
There were five deaths from Scarlet Fever, this is below
the average of the last ten years, 30 cases were
removed to hospital, where four died.
The mortality from Diphtheria was very high, there
were no less than 30 deaths, yet the total number of cases
was not great, nor was the epidemic extensive.
As far as can be ascertained without the aid of compulsoiy
notification of infectious diseases, one of every
two recorded cases was fatal, although doubtless there
were many slight cases that escaped detection.
The mortality was equally large in many other parts
of London. The Registrar General in his annual summary
says that " the deaths from diphtheria in the
Metropolis not only exceeded the decennial average
during the year 1888, but were higher than in any single
year in the period in which diphtheria has been recognized
as a distinct heading."
It may well be asked why diphtheria should suddenly
become so general and fatal with our yearly improvements
in sanitation. The answer may be probably found
in the circumstance that its spread is in the main, due to
direct infection.
In my contribution to last year's Annual Report I
called attention to the importance of isolation and hospital
accommodation for diphtheria, which then shewed
signs of its approach in the wake of the wide spread
epidemic of scarlet fever that pre vailed in London during
1886 and 1887
Early in October, 1888, the medical officers of health
of the Wandsworth Board addressed a letter to the Sanitary
Committee, calling attention to the increase of