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30
The number of cases of cerebrospinal and post-basic meningitis notified during
the year 1923 was 70, as compared with 86 for the previous year. The disease has
continued to decline progressively since the epidemic year 1915. Of the 70 cases
notified, 10 were not regarded as genuine cases ; on the other hand 22 cases were
recorded (mainly through the Registrar General's Death Returns) which were not
notified under the Public Health (London) Act, 1891. The actual number of cases
was therefore 82 of which 63 (76.8 per cent.) proved fatal, as compared with a mortality
rate of 82.5 per cent, the previous year.
The number of cases of poliomyelitis and polioencephalitis notified during 1923
was 112 as compared with 40 the previous year. As will be observed in the table
below the incidence of the disease was higher during the year under review than in
any year since 1916. Of the 112 cases notified 5 were not regarded as genuine cases,
and one recorded case was not notified, thus making a total of 108 actual cases,
of which only 7 were attended by fatal result.
During 1923 there were 101 cases of encephalitis lethargica notified. In 18
cases the diagnosis was revised, whilst two cases were not notified, thus reducing
the total number of actual cases to 85 ; of which 39 (45.9 per cent.) proved fatal
as compared with a fatality rate of 53.6 per cent, in the preceding vear.
Poliomyelitis,
polioencephalitis
and
encephalitis
lethargica.

Plague and
cholera.
Anthrax.
Typhus
fever.
No cases of plague or cholera were notified during 1923. Contacts on board
vessels arriving in the Port of London were kept under observation.
During 1923 only 4 cases of anthrax occurred in London, of which 3 were fatal.
In one case the source of infection was not definitely determined, but the patient
was employed in the London Docks and was said to have been connected with the
shipment of horses. In two other cases the patients were employed at a wharf
in handling Russian horsehair. The superintendent of the wharf was advised by
the medical officer of health of the borough to take the necessary precautions in
dealing with horsehair. The fourth case was that of a child, aged three years,
whose father was employed at a wharf in handling Chinese and Japanese hides ;
it was understood that Russian horsehair and bristles were also received at this
wharf but that the child's father had not handled the material, although he had
cleared out a quantity of rubbish at the wharf. This case was somewhat unusual,
being an illustration of the possible conveyance of anthrax infection through an
intermediary, assuming in the absence of any other ascertainable source that the
father carried the infection home to the child.
No cases of typhus fever were notified in London during 1923.
Cerebrospinal
fever.