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76
MALARIA.
Two cases were notified. Three deaths were registered as having been due to Malaria,
but none of these cases had been notified. In every case the disease had been contracted
abroad.
DYSENTERY.
Five cases were notified. The cause of the disease proved to be Flexner's Bacillus in
three cases, all of which occurred in one house. In the other two cases the diagnosis of
dysentery was not confirmed. No deaths were reported.
MEASLES AND GERMAN MEASLES.
These diseases are compulsorily notifiable in St. Pancras under Special Regulations
sanctioned in 1920. All cases are notifiable by parents or guardians, but only the first case
occurring in a house during an outbreak is notifiable by the medical attendant. An interval of
two months since the previous case constitutes another outbreak. From 1916 to 1919, inclusive,
these diseases were notifiable throughout the whole of England and Wales ; but at the end
of the year 1919 notification was abandoned by order of the Ministry of Health. In a few
districts, St. Pancras being one, notification was retained.
Hospital Accommodation.
During 1927 a decision to abandon the previous practice of always admitting cases
of scarlet fever to hospital in preference to measles was adopted. Under the new
arrangement, when the incidence of infectious disease is such that the supply of beds is
sufficient for all case3, medical practitioners will be able, as in the past, to secure the removal
of a patient by direct application to the Metropolitan Asylums Board. During epidemic
periods, however, cases of either disease will only be admitted on the recommendation of the
Medical Officer of Health. At such periods the selection of cases for hospital will depend on
wheiher the home conditions are suitable for treating an infectious patient, and it is designed
to take into account the fact that measles has now a higher mortality rate than scarlet
fever.
The epidemic of Measles which commenced in December, 1927, became very severe in
the early part of 1928 and the scheme for hospital treatment outlined above was put into
operation. The results obtained, which are discussed below, are discouraging, but information
from other boroughs and statistics on a larger scale are necessary before any definite opinions
can be expressed.
During'the year 3876 cases of Measles and 88 of German Measles were notified. 704
cases were admitted to hospitals. The services of a nurse were provided, in all cases where this
was desired by the medical attendant, in connection with cases kept at home. 127 deaths
occurred.
Measles in a very serious disease and particularly dangerous to young children. The
following statistics of the 1927-8 outbreak have therefore been extracted with reference to all
cases and for each year of age in those under 5.
In table I, below, all notified cases of Measles in children under 5 years of age are
arranged in groups according to their age in years. The table shows also the number of such
children, arranged in the same manner, who were removed to M.A.B. hospitals, Highgate
Hospital, and nursed at home respectively. The deaths and death rates are treated in a similar
way.
When children in the same age group are compared, there is revealed a very striking
contrast between the mortality rates in hospital and those at home, which appears to be very
much in favour of the latter.