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Discharge Notices.—The number of certificates received from the Metropolitan
Asylums Board regarding the return of. patients sent to hospital with infectious
diseases was 322 and referred to 446 cases. Visits were paid to these cases by the
District Inspectors, and advice given as to date of the return of children to school and
the advisability of obtaining treatment for and isolation of any suffering from any
sequel of a disease.
Diphtheria and Membranous Croup.
Diphtheria was less prevalent in 1920 than in any year since 1909, the actual
number of cases being 119. The number in 1919 was 154. Of the cases 8 died,
and the case mortality rate was 6.7 per cent.
The number of cases per thousand of the population was 1.16.
Throughout the whole year nothing in the way of grouping of the cases suggested
that there was anything like an outbreak of the disease. The cases, indeed, were
more or less evenly distributed and only in a few instances was it possible to
determine accurately the source of infection. In 6 it proved to be in the home of the
patient, and in 4 cases was derived from a member of the family previously infected.
The number of swabs from doubtful cases submitted for bacteriological
examination was 454. A positive result was returned in 54 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 37, just over half the number in 1919. In All Souls the number was 22, in
St. Mary, 36, and in St. John, 24.
As usual the age groups 1-5 and 5-15 were those most affected, 23 of the cases
falling into the former and 51 into the latter group.
Four applications for a free supply of antitoxin under the Diphtheria Antitoxin
(London) Order, 1910, were received.
The nuisances detected during the course of investigating the notified cases
were : Dirty Premises, etc., 20. These were all remedied after service of notices.
Scarlet Fever.
In many parts of London this disease was markedly epidemic and it is not
surprising, therefore, that the figure for 1920 was so high as 435. In 1914, when
the disease was also epidemic, the figure reached 432. It has already been
explained that scarlet fever tends to become epidemic at intervals of about 5 years
and the increase in this case is explained by this. No doubt the figure for 1921 will
be lower and there will be more or less of a continuous decline thereafter for a few
years.
The highest number of cases reported in any one week it may be noted was 25.