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reduced to a very low figure. It is usual to find in fatal cases
that the parents have viewed the condition lightly and have not
called in the doctor until the child is in an advanced stage of the
disease. Delay in the administration of anti-toxin is fraught
with so much danger that the doctor, whenever there is suspicion
of the cases being of diphtheria, should not wait for bacteriological
confirmation of the diagnosis, but should give anti-toxin at once.
Some cases are so rapid in progress and so fulminating in type
that an hour's delay may make a vast difference in the progress
in the disease and in the chances of the patient's recovery.
To assist in the early administration of anti-toxin, a supply
can be obtained by doctors at any time of the day or night, either
at the Town Hall, Ealing, or at the Health Centre, Cherington House,
Hanwell. This anti-toxin is provided free of charge when the
parents of the affected child are not able to afford to pay for it.
During the year 234,000 units of anti-toxin were supplied to doctors
for administration in this way.
Scarlet Fever.— The number of cases of scarlet fever, 313,
is the largest in any year since 1922 when the number of cases was
487. The month of greatest prevalence was May, during which
57 cases occurred. It was then thought that, as the disease had
got its hold on a very susceptible young population which had not
been attacked by the disease in epidemic form since the years 1921
and 1922, the autumn would show a violent outbreak of the disease.
Fortunately the anticipations proved to be wrong, for with the
closure of the schools at the end of July there was a marked fall
in the number of cases in August and in September there were only
15 cases. In October, however, the number rose to 43, but again
fell in November and December to 19 and 24 respectively.
It cannot be said that any Ward suffered particularly, even
in May the cases were widely scattered throughout the town with
little discernible connection between them.
The disease was very mild in character and no deaths have
to be recorded. This is the third year in succession during which
there have been no deaths from scarlet fever. It is worth noting
for comparison that the death-rates for scarlet fever for England
and Wales and for London were respectively 0.01 and 0.02 per
1,000 of population.