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Schick test, of those special sections of the adult population who come
into closest contact with groups of young children.
On the efficacy of immunisation against the disease, although the
numbers concerned are small and therefore not conclusive, it is suggestive
that during the last six years only one child in 1,000 of the estimated
immunised child population of the District has contracted the disease,
whereas one in 400 of the corresponding unimmunised group of children
has suffered from diphtheria.
The national figures are even more impressive.
In the seven war years only two deaths have occurred in this District
from this disease, viz., one child in 1942 and one adult in 1945.
To summarise the position in 1945, there were 15 notifications, 12
in a mental hospital and three, including two adults, among the general
population. All three cases were treated at the Wandle Valley Isolation
Hospital, where one adult unfortunately died. The only juvenile case
was in an unimmunised child, and in his case no secondary cases arose
in the school, while neither his older sister, previously immunised, nor
baby brother, unimmunised, contracted the disease.
A further note on the Immunisation Scheme is to be found later in
the Report.
Scarlet Fever.
During the war years the fluctuations in the number of cases of
scarlet fever notified annually have corresponded with the variations
experienced nationally, the most prominent feature being the sudden
increase in 1943, in which year 184 cases were notified locally. This was
the highest number of cases ever notified in the District and followed a
succession of years in which the prevalence had been low. The only
other interesting point locally was an outbreak which affected Reedham
Orphanage in 1940, when overcrowding in the shelters was a contributory
factor. Sulphonamide tablets were administered as a preventive
measure, and only 20 cases occurred.
It has been noted during and since the 1943 epidemic that a greater
proportion of children has been affected than in previous outbreaks, but
the most important tendency in recent years, and the one which has
greatly complicated preventive measures, has been the mildness of the
disease, coupled with the large proportion of persons infected who have
failed to show the characteristic rash. It is only when this symptom is
present that notification is required, whereas isolation and treatment are
equally desirable for all forms of the infection.
No death has occurred in the District from this disease since 1932,
although it was the cause of five deaths in the previous 10 years.
A further decline in the prevalence of scarlet fever occurred during
1945, when the number of cases notified was 67, as compared with 88 in
the preceding year and 184 in 1943. The disease, which remained very
mild in type and was most prevalent among children of school age, was
fairly evenly distributed throughout the District and throughout the
year. Towards the end of the year a considerable amount of tonsillitis
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