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41
The cost of carrying out the requirements of the Public Health (London) Act,
1891, and the various regulations with regard to notification was -£('>1 13s. Od.,
equal to 12s. per 1,000 of the population.

Discharge Notices.—The number of certificates received from the hospital
authorities regarding the return of patients sent to hospital with infectious diseases
was 350, and referred to 465 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.
The number of cases notified was 271, the number in 1929) being 180. Of the
cases 12 died, and the case mortality rate was 6.6 per cent.
The number of cases per thousand of the population was 1.7.
The cases were more or less evenly distributed, as usual, throughout the
borough, and only in a few instances was it possible to determine accurately the
source of infection. In 9 cases the source appeared to be a member of the family
previously infected ; in 5 cases infection was counted to have been acquired in
school, and in 16 cases in an institution.
The number of swabs from doubtful cases submitted for bacteriological
examination was 3,189. The bulk of these were from institutions, St. Charles,
and the Royal National Orthopaedic Hospitals, from which many of the cases were
notified, and were taken from ward contacts. Fortunately nearly all proved
negative, a positive result actually being returned in 213 instances only.
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 97. In All Souls the number was 71, in St. Mary 58, and in St. John 45.
As usual, the age groups 1—5 and 5—15 were those most affected, 103 of the
cases falling into the former and 99 into the latter group.
No 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., 31. These were all remedied after service of notices.
The Schick Testing and Diphtheria Immunization Clinic opened at the beginning
of 1928, continued to operate at the Lissonia Centre throughout the year,
the work being in the hands of Dr. Margaret Emslie, and later of Dr. H. A.
Bulman. In the main the children dealt with were those attending the Welfare
Centres.