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occur without rose spots, diarrhoea, without abdominal distension
tenderness, and without enlargement of the spleen.
Pyrexia and agglutinin in the blood may be the only signs.
In one infant of 13 months under my care with rose spots and
an enlarged spleen the highest temperature recorded whilst
under observation was only 100.6° F.
The examples of Enteric Fever in infants that have been
brought to my notice arose where that disease was present in
the house and they were obviously infected.
In young children the disease suggests rather some
cerebral affection than an abdominal complaint, for constipation,
a retracted abdomen and brain symptoms are not uncommon
in them. The disease is apt to be mild and shortened
and a sudden onset is not uncommon with sickness, fever and
prostration.
The agglutination test cannot be relied upon always to
assist the diagnosis. Therefore in the presence of Enteric
Fever in the house, if any of the infants or young children
are attacked by an ill-defined complaint, Enteric Fever
should be suspected. In all doubtful or suspicious cases the
same precautions must be adopted as in the declared disease,
and they should be reported to me.
Measles.
The Bromley Road Schools, Infants' Department, was
closed for Measles for two weeks during the month of May.
There were 5 deaths notified.
Whooping Cough.
Two deaths were notified during the year from Whooping
Cough between the age of 1 and 5 years. The previous year
there were 4 deaths from this disease.