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7
SMALLPOX.
Smallpox was imported into the district in April from a
P. & O. steamship (see "Sanitary Chronicles," April and May).
Four cases were notified. By means of prompt removal to
hospital, retention in the shelter of persons who had been in
contact with the patients, revaccination, and disinfection, there
was no spread.
SCARLET FEVER.
Scarlet fever (as shown by the curve, opposite page 16)
was generally below the average up to the end of October. In
that month there occurred a localized outbreak in the St. Marylebone
Charity School for Girls; the effect of this outbreak is
clearly seen in the rise of the curve in the 43 rd week. The
seasonal maximum, which usually takes place in the first week
of October, was displaced to the last week of October.
The outbreak and the measures which were so successful
in controlling it have been detailed briefly in the " Sanitary
Chronicles" for October, 1900. From a medical point of view
the illness of the children possessed some unusual features.
With a few cases of undoubted ordinary genuine scarlet fever,
there were several others in which a diagnosis was difficult, the
more especially if they were considered alone and without
reference to the true cases. The safe course, however, was
taken, so far as isolation and other preventive measures were
concerned, of considering all the patients suffering from a mild
attack of an infectious fever. The total number of cases of
scarlet fever notified in the whole district during 1900 was 358;
of these 18, or 5 per cent., terminated fatally. This is equal
to a mortality per million living of 125.
Partly owing to a change of type in the disease, partly to
early isolation, and improved methods of medical treatment,
scarlet fever has altered its character.
Formerly a malignant malady, leaving in a large percentage
of cases that recovered, deafness, or more or less permanent
injury to the kidneys, or both, at the present time a vast number
of cases produce scarcely as much disturbance as a common cold.
MEASLES.
Measles was twice as fatal as scarlet fever, 36 deaths
being registered from that cause—equal to a death-rate
per million of 254. There is neither notification of measles nor