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The treatment of the disease has improved very considerably with
the introduction of the sulphonamides and penicillin, but it has appeared
undesirable to use these drugs prophylactically as a routine measure for
fear of encouraging the development of strains of streptococci which are
resistant to them. Their future use for treatment might in this way be
prejudiced. Occasionally, however, both drugs have assisted prevention
of the spread of the disease.
Erysipelas.
A total of 8 cases was notified during 1946, compared with 4 in 1945,
and of these 3 were mental hospital patients. Two cases were admitted
to the Isolation Hospital for treatment and all recovered.
This disease, although caused by a streptococcus, has never been very
prevalent in the District and the slight increases which have occasionally
occurred have tended to precede the waves of scarlet fever. It is very
exceptional locally to meet cases which are associated directly one with
another.
Puerperal Pyrexia.
While there were only 2 notifications of this disease received in this
District during 1946, this being the same number as in 1945, a total of
9 residents was removed to the Isolation Hospital suffering from puerperal
pyrexia during the year. The 2 notified cases were removed from a local
Nursing Home, presumably having contracted the infection from a member
of the staff who was carrying streptococci in her nose. The other 7
cases contracted the disease at Purley Hospital, 5 in May, 1 in July and
1 in August, but were notified to the Croydon Public Health Department
as having developed the disease in that District.
Fortunately all the cases recovered.
There were comparatively very few cases of puerperal fever notified
during the first 15 years of the history of this District but this may have
been due to the failure to notify cases which would now be brought to
the notice of the Department. In 1932 and 1937-8 there were increases
to 6 or 7 cases per annum but since the beginning of the war the number
of cases has been very low in spite of the prevalence of streptococci
among the general population and the difficulties under which midwives
have worked. Fortunately the introduction of the newer drugs has improved
the outlook for actual cases during the last decade but it is hoped
preventive measures will in future be more successful than in 1946. The
overcrowding of maternity departments which is liable to occur with the
relative reduction in accommodation and staff is, however, apt to increase
the risks.
Enteric Fever.
Three cases of typhoid and 1 of paratyphoid were notified during
1946, compared with 2 of each during 1945. Of the cases of typhoid, 2
occurred in patients at one of the Mental Hospitals in February and the
other was a child who contracted the disease in Ireland. The origin of
the 1 case of paratyphoid could not be traced.
Locally this group of diseases was much more prevalent in the first
decade of the District's history than of late, when increased numbers
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