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with the mild and often Unrecognised form of Scarlet Fever now prevalent.
The fact that during the year in only 20 instances did secondary
cases follow primary ones in the home (three of these being swab positive
only) suggests that the limitation of cases has continued satisfactorily.
NON-NOTIFIABLE INFECTIOUS DISEASE.
The group of non-notifiable Infectious Diseases, with the exceptions
of Influenza and Measles, caused no deaths during 1936, which was a
fairly mild year as far as these diseases were concerned. Influenza
accounted for 6 deaths in adults, three of whom were over 80 years
of age, while one newly-born infant died of measles. Apart from the
death returns, the only source of information as to the presence of
outbreaks of non-notifiable Infectious Diseases are the returns received
from the public elementary schools.
As judged by these, the only outbreaks of note were:—
CHICKEN POX.—There were isolated cases scattered over the District
in January and February, but in the next four months there was quite a sharp
outbreak all over the area and especially at Selsdon. A number of cases also
occurred in the Autumn, chiefly in Coulsdon.
MEASLES.—From January to March there was an epidemic affecting
all parts of the area. Selsdon was chiefly affected in January and February,
and Coulsdon in February and March.
MUMPS.—There were a few cases in Coulsdon West and Smithambottom
in March which increased in numbers in May and June, spreading to Coulsdon
East. The numbers continued to increase in Smithambottom from October
to December, while a number of cases occurred in Purley in the last two months
of the year.
WHOOPING COUGH.—Comparatively few cases occurred, chiefly in
Sanderstead in March and April, and in the other parts of the area from May
to July.
Home visitation and exclusion from school are the two chief
measures relied on to postpone the onset until a more favourable age
is reached to stand the disease. Treatment in Hospital is provided
for a limited number of cases, and 2 cases of Measles were admitted
to the Isolation Hospital during the year under this arrangement, social
or physical complications being present.
Arrangements with the Immunisation Centre of Great Ormond
Street Hospital exist, whereby cases in which there are special reasons
for immunisation against Measles or Whooping Cough may be referred
to this Clinic by the Medical Officer of Health. The Council, however,
reserve the right to recover all, or part, of the cost of treatment. Similar
facilities have also been arranged for immunisation against Scarlet
Fever. To date no use has been made of this facility, immunisation
being undertaken by the patient's own doctor in the few cases which
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