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131
Special attention is directed to the treatment of all cases of disease of the eyes
through the Council's "treatment" scheme.
The health of the children at the Council's residential institutions for children
of school age was highly satisfactory as regards the incidence of infectious illness.
Only a few sporadic cases of infectious disease occurred at one or other of these
institutions. It is probable that in the few cases that occurred, the infection
was introduced by visitors or that the patients were incubating the disease before
their admission. Precautionary measures regarding isolation of the patients and
close observation of the contacts were successful in preventing any spread of
infection.
Residential
schools and
places of
detention.
I he subject of encephalitis lethargica as a whole is reviewed in that section or
the annual report dealing with the general public health. In view of the fact that
this disease, as regards its sequelæ, presents a specially difficult problem in relation
to children of school age, it will be appropriate to make reference to the subject in
this section of the report.
The number of children of school age notified during 1926 as suffering from
encephalitis lethargica was 53, the total number of notifications for this disease
among persons of all ages being 231. The following table presents an analysis of
the notified cases between the ages of 3 and 14 years during 1926 as compared with
1925. It will be noted that the diagnosis of encephalitis lethargica in 10 cases
was not confirmed. Of the remaining 43 cases, 15 died, and 8 were still suffering
from the sequelæ of the disease at the time of the last report. With regard to the
15 children who were said to be apparently normal, it must be remembered that
relapses are common and that frequently an intervening stage of normality occurs,
after the acute stage, before the after-effects appear. In this connection it will
be noted that in the 1925 figures, in which a sufficiently long interval has elapsed
to allow of the sequelæ to become manifested, the number of children still suffering
from after-effects exceeds the number of those apparently normal.
Encephalitis
lethargica
("Sleepy
sickness").
Total
notified.
Apparently
normal.
Suffering from
after-effects.
Not confirmed
as E.L.
Fatal.
No
information.
M. F. M. F. M. F. M. F. M. F. M. F.
1925 22 25 6 6 10 5 3 3 2 11 1 -
1926 36 17 10 5 6 2 6 4 10 5 4 1
In addition to the 53 notified cases during 1926, 107 cases under the age of 16
years, notified in previous years as encephalitis lethargica, came under observation
or were investigated from time to time. Further, there were 134 non-notified cases
in this age period on which one or more reports were obtained during the year, apart
from those treated at the Northern Hospital, Winchmore Hill, to which reference
is made later. These cases are classified according to the nature of the sequelæ
in the following table. The various categories broadly conform with the classifications
given in the report of the Metropolitan Asylums Board on the first year's
working of the experimental unit at the Northern Hospital, and are as follows:—
Mental.—Intelligence affected in a greater or less degree, ranging from
mental hebetude to imbecility.
Conduct changes.—These cases range between those showing excitability
and emotional outbursts to those of the gross forms of delinquency exhibiting
maniacal behaviour, pilfering, sexual perversity, etc.
Parkinsonism.—A characteristic condition associated with muscular
rigidity, slowness of movement, nodding head, dribbling, tremors, etc.,
resembling the paralysis agitans of old age. These cases vary from the mild
Parkinson type to the helpless and bedridden case.
Excito-Motor.—Includes cases exhibiting involuntary movements, coarse
tremors, myoclonic spasms or twitchings, choreic or jerky action of the limbs,
and muscular contractions, etc.