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39
Diphtheria and Membranous Croup.
Diphtheria was more prevalent in 1921 than in any year since 1901, the actual
number of cases being 239. The number in 1920 was 119. Of the cases 24 died,
and the case mortality rate was lO'O per cent.
The number of cases per thousand of the population was 2'1.
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 12 it proved to be in the home of the
patient; in 18 cases the source was a member of the family previously infected ; and
in 10 cases in school.
The number of swabs from doubtful cases submitted for bacteriological
examination was 685. A positive result was returned in 78 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 79, just over double the number in 1920. In All Souls the number was 51, in
St. Mary, 42, and in St. John, 67,
As usual the age groups 1-5 and 5-15 were those most affected, 49 of the cases
falling into the former and 109 into the latter group.
Two 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., 49. These were all remedied after service of notices.
Scarlet Fever.
In many parts of London this disease was markedly epidemic and it is not
suiprising, therefore, that the figure for 1921 was so high as 478. In 1920, when
the disease was also epidemic, the figure reached 435. It has already been explained
that scarlet fever tends to become epidemic at intervals of about 5 years, but to find
a year showing anything like so large a number of cases it is necessary to go so far
back as 1896. In having such a prevalence St. Marylebone did not differ from other
Boroughs in the Metropolis, many of which were more seriously involved in the
epidemic.
The highest number of cases reported in any one week it may be noted was 28.
The total deaths from scarlet fever numbered 5, and the number of deaths per
cent, of the cases was 1.04.
The districts to suffer most from this disease were Christ Church and St. Mary.
In the former there were 199 cases and in the latter 118. In All Souls there were
81 and in St. John 80.
As usual the majority of patients were children of school age, the age group,
5-15, giving nearly two-thirds (311) of the total. Of the remainder 80 were aged
between 1 and 5 years.
The source of infection was believed to be a previous case in the same family
in 34 cases. In 11 cases a patient had been previously notified to be suffering in the
same house, and in the neighbourhood, 12 cases.