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was confirmed by bacteriological examination. Suspension from
duty of the worker, until positive proof of freedom from infection
was obtained, quickly brought the outbreak to an end.
PUERPERAL PYREXIA.
Thirty-four cases were notified: of these, 29 occurred in the
Beckenham and Penge Joint Maternity Hospital, 2 in a private
nursing home in the Borough, 1 in King's College Hospital and one
in the patient's own home.
Under the Puerperal Pyrexia Regulations, 1939, puerperal
pyrexia means any febrile condition occurring in a woman within
21 days after childbirth or miscarriage in which a temperature of
100.4° F. or more has been sustained during a period of 24 hours
or has recurred during that period.
The causes to which the pyrexia in the cases notified were
attributed were as follows:—
INFECTIONS.
Urinary infectious (Bacillus Coli) 8
Mastitis 7
Toxaemias of Pregnancy 5
Local Sepsis of pelvic organs and tissues 5
Septicaemias 1
Phlebitis (post-operative) 1
Acute otitis media 1
Pneumonia 1
Bronchitis 1
No discoverable cause 4
MEASLES.
The cases notified in Beckenham were 198 and 34 in West
Wickham. As mentioned in previous Annual Reports, Measles has
departed from its very regular biennial cycle during the war ; it
will be interesting to observe if it returns to its regular rhythm when
large-scale fluctuations in the child population have ceased. It is as
vet too soon to draw anv conclusions.

OPHTHALMIA NEONATORUM.
No cases were notified.
38