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18
WHOOPING COUGH.
There were 15 deaths from Whooping Cough: 2 of these
occurred in the Isleworth Infirmary.
The disease was most prevalent during the second and fourth
quarters. No deaths resulted in the third quarter and only one in
the first.
Under present conditions, Whooping Cough is the most
difficult of infectious diseases to control. The difficulties arise from
many causes. Not only is the nature of the virus unknown, but the
length of the infection is doubtful. Moreover, the disease is
infectious before a diagnosis can possibly be made. It is true that
the same remark applies to Measles and Scarlet Fever, but in the
two latter diseases, the initial symptoms are fairly characteristic
whilst in Whooping Cough, in the catarrhal stage, the child has the
symptoms of an ordinary cold, and there is nothing to distinguish
the cough until it assumes its "whooping" character. The
paroxysmal stage marked by the characteristic cough does not
usually manifest itself until a period of a week or ten days has
elapsed, and during the whole of this time the child is infectious.
Another difficulty lies in the age of the persons attacked. The
Registrar General in his Annual Report for 1891 discusses the
diseases to which infants succumb. He says "Very notable is the
comparative immunity of infants in the earlier months from the
several Zymotic diseases. The earliest to declare itself is Whooping
Cough, which is the assigned cause of some deaths even in the first
month, but becomes much more frequent later on; next comes
Measles, but with no great number of deaths until the eighth
or ninth month is reached, after which it takes many victims;
while Scarlet Fever is still later in its appearance, and scarcely
carried off any infants at all in their first year."
This peculiarity in the behaviour of W'hooping Cough is
specially noteworthy; it renders the application to it of preventive
measures compared with other Zymotic diseases particularly difficult.