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occurred in the Coulsdon end of the District, but not being accompanied
by the characteristic rash, cases were not notified, and only detected in
the course of routine school examination.
Erysipelas.
Of the 94 cases which occurred during the seven war years, 54
occurred in the mental hospitals while the remainder, of which 10 were
admitted to hospital, were all isolated cases occurring throughout the
District. No deaths from this disease were reported.
There were only four cases of erysipelas during 1945 and of these
one occurred in a mental hospital. One case was admitted to the
Isolation Hospital and all recovered.
As this disease is, like scarlet fever and puerperal fever, caused by a
streptococcus, it is interesting to note that increases in the number of
cases of erysipelas occurred in 1932 and 1941/2, thus tending to precede
the peak periods for scarlet fever, which occurred in 1929, 1935 and 1943.
Puerperal Pyrexia.
Only two cases of puerperal pyrexia were notified in 1945, and this
is the average number for each of the seven war years. These two
cases, one mild and one serious, occurred in Purley Hospital and were
removed to the Wandle Valley Isolation Hospital, where both recovered.
All but two of the cases which have occurred since 1938 have been similarly
admitted, and only one death has been registered, that occurring
in 1939.
Enteric Fever.
Two cases of typhoid and two cases of paratyphoid fever were
notified during the year, all of which occurred in one or other of the
mental hospitals. No deaths resulted.
During the last seven years, a total of 22 cases of typhoid has been
notified, of which 18 occurred in the mental hospitals, the largest
number in any one year being eight in 1940. Only one death from the
disease occurred, viz., in 1944.
During the same period 62 cases of paratyphoid were notified, of
which 55 were in the mental hospitals. The chief outbreak was in 1940,
when 45 cases were detected, 44 being mental hospital cases infected with
Bacillus paratyphosus B., approximately half of these cases being only
carriers, however. Four deaths occurred. In addition, of the seven
normal residents of the District who contracted the disease between 1939
and 1945, one died in 1943. All the usual precautions were taken to
prevent outbreaks of these diseases in the mental hospitals, including
inoculation. Unfortunately the source of the 1940 outbreak could not
be traced.
Dysentery.
The number of cases of dysentery notified during 1945, viz., 172,
was the second highest recorded in the District. Of these cases, 171
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