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The incidence of diphtheria showed a considerable decrease in
1931. The mortality was 3.2% in the Hospital cases. The type
was decidedly more severe than in 1930.
Forty-one cases of bacteriological Diphtheria were admitted,
but these are not included as diphtheria as they exhibited no clinical
symptoms.
The Case rate (Col. 3) for England and Wales was 127.
Croydon's rate is therefore considerably lower than for the whole
country.
SMALL POX
An outbreak occurred in Croydon, lasting from February
23rd until May 9th. A total of 49 cases were diagnosed and investigated.
The disease was of the prevalent mild type and indeed its
most disturbing feature was its name. As a clinical entity, the
majority of the cases have been less severe than ordinary cases of
Chicken-Pox. The results of vaccination in the contacts have also,
in a few instances, been more severe in their effects than the
actual disease. There is, however, no means of knowing if or
when the more serious type may arise consequently a trivial complaint
must be handled as if it was a matter of much greater
consequence.
Its infectivity varied, in some cases it appeared more liable to
attack contacts than in others, but as a whole it was not very
infections, when the unvaccinated condition of the community is
remembered. The present modified form is most decidedly less
infectious than the old type of the disease. The same characteristic
was observed in outbreaks with which I had to deal in
Lancashire and Yorkshire. The history of Small Pox in England
during the past few years shows that it broke out in the extreme
North of England and has gradually passed southwards. The
North is now practically free, but for the past 2½ years it has been
very prevalent in London and neighbourhood. Until the visitation
under review only a few odd unconnected cases occurred in Croydon,
viz., 2 in 1929 and 24 in 1930.
The usual procedure was carried out. Among other details
this comprised,
(a) Recommendation of vaccination to all contacts.