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73
SCARLET FEVER.
The number of cases notified was 618, as compared with 527 cases during the previous
year. It was subsequently ascertained that 45 cases had been incorrectly diagnosed. The actual
number of cases was therefore 573. One death occurred ; this equals a case mortality of 0.2
per cent.
Return Cases.— This term is applied to cases of Scarlet Fever which occur in a house
within 28 days of the return from hospital of a previous case. 11 such cases occurred
during the year. Two cases occurred in one house, and were due to the same source of
infection. One of the suspected sources of infection was suffering, when discharged from
hospital, from nasal discharge. The remainder showed no obvious signs of being infectious.
DIPHTHERIA.
The number of cases notified was 407, as compared with 390 cases during the previous
year. It was subsequently reported by the hospital authorities that 57 cases had been incorrectly
diagnosed, the actual number of cases was therefore 350. This equals an attack rate of 1.7
per 1,000 of population. Twelve deaths occurred, giving a case mortality of 3.4 per cent.
Antitoxin for the treatment of cases of this disease is supplied to medical practitioners
free of charge by the Council. During the year 200 thousand units were provided.
ENTERIC (TYPHOID) FEVER.
Twenty-one cases were notified and one case was discovered after death. On further
investigation four cases were found to have been incorrectly diagnosed. The actual number
of cases was therefore 18. Based on bacteriological examination, 11 cases were reported to be
suffering from Typhoid and 5 from Para-typhoid fever. In the remaining cases no definite
bacteriological information was available.
Two deaths occurred, one from Typhoid and the other from Para-typhoid. During the
summer months an epidemic of Para-typhoid, caused by infected cream, occurred in London and
surrounding districts, but no cases occurring in St. Pancras were traced to this source.
In November, a slight epidemic of Typhoid commenced. It was limited to a small area in
the Borough, and was found to be due to the consumption of infected winkles. Altogether 12
persons were affected, the last 2 cases being notified in January, 1929.
A sample of winkles was obtained and submitted for bacteriological investigation to
Professor Teale, of University College Hospital, who reported the winkles to be highly
contaminated with sewage germs and to be a potential source of danger, although no typhoid
bacilli were found. The wholesale merchant from whom the winkles were bought was traced,
and it was found that his supplies were obtained from a very large number of different places,
English and Foreign. The retailer was instructed to boil the winkles for a longer period in
order to remove the risk of infection, and the matter was reported to the Ministry of Health
and the Board of Agriculture and Fisheries.
PUERPERAL FEVER,
19 cases were notified. On further investigation the diagnosis of one case was not
confirmed. In addition to the notified cases it was found that 12 cases of Puerperal Pyrexia
should have been notified as Puerperal Fever, and three other cases were brought to notice on
special death reports. Thus the total number of cases which occurred during the year was 33,
producing an incidence rate of 10.1 per 1000 births. Four deaths occurred, but of these one was
found to be due to illegal interference with pregnancy, and is consequently not allocated to
puerperal fever but to violence. The case mortality rate was 9.1 per cent, and the death rate
0.9 per 1000 births.