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DIPHTHERIA.
The incidence of this disease remained at a very low level throughout
1938, following a wave which lasted from the Autumn of 1934 until the
early summer of 1936.
Only 10 cases were notified during the year compared with 8, 35,
52 and 52 in the preceding four years. This number represents one of
the lowest incidences experienced in the District since its constitution
in 1915, bearing in the mind the increasing population.
Of the 10 cases, three were in adults, two of whom probably
contracted the disease whilst working in London, and the other while
a patient in a hospital outside the District. One of the juvenile cases
followed the visit to the home of a convalescent diphtheria case, while
four children who developed the disease within a few days of each other,
attended the same school.
Only one of the 10 cases had obtained any form of immunisation
treatment, and this case had only received two injections without being
tested afterwards to ascertain their efficacy. The onset of the disease
within a year of treatment proved that in this case insufficient immunity
had developed.
No deaths from this disease occurred during the year.
It is probable that the small number of cases for two years in
succession should not be attributed to the practice of diphtheria
immunisation in the Urban District. While a number of children have
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 locally.
Inspection of Table III at the end of the Report will reveal that
waves of diphtheria have been experienced locally in 1921-22, 1924, a
slight one in 1929, and again in 1934-36. At present a trough, similar
to those intervening between the previous waves, is being passed through,
and while this may last 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.
Three cases of typhoid fever were notified, two of which occurred
amongst the inmates of one of the Mental Hospitals. In the remaining
case the infection was thought to have been contracted through eating
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