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53
accurately the source of infection. In 20 it proved to be in the home of the patient,
and in 10 cases was derived from a member of the family previously infected.
124 patients were believed to have obtained infection from a previous case in the
neighbourhood.
The number of swabs from doubtful cases submitted for bacteriological
examination was 424. A positive result was returned in 73 instances.
Of the registration districts, that contributing the largest number of cases,
naturally, since in respect of child population it is the largest, was Christ Church,
with 64. In All Souls the number was 28, in St. Mary, 21, and in St. John, 40.
As usual the age groups 1-5 and 5-15 were those most affected, 45 of the cases
falling into the former and 77 into the latter group.
Five applications for a free supply of antitoxin under the Diphtheria Antitoxin
(London) Order, 1910, were received during the period, when difficulties in connection
with removal to hospital were most marked.
The nuisances detected during the course of investigating the notified cases were :
Dirty Premises, etc., 42. These were all remedied after service of notices.
Scarlet Fever.
The notifications of this disease numbered 197. Having regard to the fact that
in many parts of London the disease was markedly epidemic this must be regarded
as remarkable, even if it is higher by 117 than the figure for 1918 (80). That there
is a tendency for scarlet fever to show epidemic tendencies at intervals of five years,
more or less, is well known. It is borne out by the experience here; 1914 and 1909,
like 1919, having given a number of cases higher than the normal, viz., 432 in the
former, and 458 in the latter.
The highest number of cases reported n any one week it may be noted was 14.
The total deaths from scarlet fever numbered 3, and the number of deaths
per cent, of the cases was 1.6.
The districts to suffer most from this disease were Christ Church and All Souls.
In the former there were 95 cases and in the later 55. In St. Mary there were 25
and in St. John 22.
As usual, the majority of the patients were children of school age, the age group,
5-15, giving nearly two-thirds (129) of the total. Of the remainder 37 were aged
between 1 and 5 years.
The source of infection was believed to be a previous case in the same family in
13 cases. In six cases a patient had been previously notified to be suffering in the
same house.
Though it seemed probable that many of the children notified acquired their
infection in school, it was only in 8 instances that a definite connection could be
made out.
Defects in sanitation to the number of 29 were discovered. All these were
want of cleanliness, etc. The nuisances were remedied after the service of notice in
each case.
Enteric Fever.
This disease was, as usual, practically absent during the year, the notifications
received numbering only 4. There were two deaths. None of the cases presented
any feature calling for special mention.
Cerebro-Spinal Fever.
Only one case of this disease, a girl 8 years old, was notified. Isolation and
treatment were carried out in a hospital, and the patient made a practically complete
recovery.