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DIPHTHERIA.
For the fifth year in succession no confirmed case of diphtheria
has occurred in the District, and this year only one suspected
case was sent to hospital.
While this achievement, which is chiefly attributable to the
health services, is one of the most satisfying in recent years,
particularly when the saving of life, illhealth, manpower and
money is considered, there has been evidence of late that the germ
of this disease has not been absent from this neighbourhood, hence
the standard of immunity of the population must not be permitted
to decline.
SCARLET FEVER.
There was a recession in the prevalence of scarlet fever in the
District during 1951, as was expected after two successive years in
which the number of cases was relatively high. The actual number
of cases was 90 compared with 149, 138, 78 and 62 in the
preceding four years. Judging by previous experience the incidence
should not increase greatly during the next year or two.
The disease remains of a very mild type, resulting in an
increase in the number of missed cases, and it is, therefore, the
more difficult to limit its spread, or to forecast the number of
cases which can be expected. In fact, when it is remembered that,
associated with each case there are almost always other persons
carrying the germ and sometimes showing symptoms of illhealth
but not developing a rash, it is remarkable that the number
notified as scarlet fever remains relatively constant from year to
year. Similarly, it is surprising that for the last 4 years almost
all the cases have been young children. It would appear that with
advancing years an immunity is developed to the rash producing
elements, though not to the same extent to the invasion of the
actual germs. In 1951 only one case was over school age and
only 7 others were 10 years of age or older.
While contact at school is not the only way of spreading the
infection, it is obvious from the distribution of the cases that this
has probably the greatest influence. (No less than 24 of the
cases attended Selsdon school).
Of the 90 cases, 47 were treated at their homes and 43 in a
variety of Isolation Hospitals. (Wandle Valley 16, Bletchingly 9,
Cuddington 6, Croydon 4, Dorking 4 and The Grove 2). On only
one occasion was a second case notified from the same house as a
primary case, and then the infection may well have been passed
before the original case, which was being treated at home, was
diagnosed.
It is clear that in the majority of cases treatment can well be
provided at home. There appeared to be justification for all
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