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residents contracted the disease when staying outside the District. No
deaths from this disease occurred during the year.
The sudden fall in the number of cases should not, of course, be
attributed in any way to the practice of diphtheria immunisation in
the Urban District. While a number of children had previously received
injections from their own doctors, and a report on those immunised at
the Clinics during the year will be found later in this Report, the total
number of children so treated is insufficient as yet to influence the
incidence of diphtheria in the District.
Inspection of Table III at the end of this Report will reveal that
waves of diphtheria have been experienced locally in 1921-2, 1924, a
slight one in 1929, and again in 1934-6. At present a trough, similar
to those intervening between previous waves, is being passed through,
and while this may last for a year or more, an increased number of
cases will undoubtedly be experienced in the future unless a much greater
response to the offer of immunisation is forthcoming. It is folly to
postpone treatment solely because the disease is now at a low ebb.
TYPHOID FEVER.
The outbreak of typhoid fever which occurred in the neighbouring
County Borough of Croydon, and affected this District received unparalleled
publicity, hence only a few notes are necessary on the disease
within the boundaries of this Urban District.
A total of 24 notifications was received, but of these 4 were not confirmed,
3 notifications proving to relate to cases of paratyphoid fever,
while in the other case the diagnosis was doubtful owing to the very
acute course run by the disease and the lack of bacteriological evidence.
Preceding and unconnected with the epidemic, a case of definite typhoid
fever which had contracted the disease in France was diagnosed in a
Nursing Home in this District. As it had been taken ill in Croydon,
notification was accepted by them and the case treated in the Croydon
Borough Isolation Hospital.
All the remaining 19 definite cases of typhoid fever occurred during
November or early December, and were thus connected in time with
the main epidemic. Of these, 14 were connected with Croydon schools
(9 being in two schools), which received the contaminated water supply.
In the remaining 5 adult cases, 1 was readily traceable to the water
supply, 2 were, after very close enquiry, shown to have had the opportunity
of being affected by the supply, the fourth worked in Croydon
and might possibly have been so affected, but in the fifth case no connection
with the supply or contact with cases could be traced.
The 19 cases were distributed as follows :—-
Selsdon 3
Sanderstead 12
Purley 3
Coulsdon 1
18