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48
before and after May. It would appear that winter and spring weather tend
to produce a high incidence rate in the disease but summer weather a high
case mortality.
Duration of Ulrntss in Fatal Cases.—Most of the fatal cases were of very
short duration, but a few drifted on to more than two weeks.
The actual figures were :—
Total Cases.
1 day's duration 5 Cases.
2 days' „ 4 „
5 ,, ,, 2 ,,
7 ,, ,, 1 Case.
8 ,, ,, 1 ,,
15 ,, „ 1 ,,
3 weeks' „ 2 Cases.
6 „ 2 „
7 ,, „ 1 Case.
21 „ „ 1 „
The fulminating character of some cases is indicated by the fact that
inquests were held in four instances.
There was some indication from the histories obtained from the patients'
friends that a certain number of .cases have a slight illness, such as malaise
and catarrhal symptoms, appear to recover, and then develop meningitis
suddeuly one or two weeks later.
Petechial Rash.—In 8 cases (3 of which recovered) there was a history of
hsemorrhagic rash. It may be that a few others also had petechiae without
my having been able to obtain such a history ; but there appears to be no
doubt that the majority of the cases did not have the feature which has given
rise to the name " spotted fever."
In four cases there was a definite history of an early transient rash of a
measles-like nature, and I am inclined to think from vague histories in other
cases that this feature appeared in more than that number of cases.
After-effects.—A striking characteristic of the St. Pancrae cases is the absence
of after-effects. Enquiries have been made into the after-history of the 17
survivors, and in the 15 cases where patients or their friends were interviewed,
the recovery was said to be quite complete, while in the two remaining cases
I have no reason for thinking it was otherwise. This is surprising in view of
the purulent condition of the cerebro-spinal fluid noted in some of the cases
during their illness.
OTHER NOTIFIABLE INFECTIOUS DISEASES.
No case of small-pox was notified in St. Pancras during 1915. Eleven
cases were reported in the County of London (exclusive of the Port), in
Fulham, Greenwich, Kensington, and Stepney.