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65
Enteric Fever.—Three cases of enteric fever were notified
during the year. One of these cases proved fatal. This was
a man 40 years of age who was taken ill while travelling home
from a holiday in South Devon. A possible source of infection
in this case was suggested by the fact that the patient was reported
to have partaken of shell-fish on numerous occasions during his
holiday. The second case was a man 50 years of age, there being
a record of the patient having frequently partaken of oysters.
In the third case, a boy 10 years of age, the only source of infection
that could be suggested was the fact that he had fallen into the
canal and was nearly drowned some weeks previously.
Puerperal Fever and Puerperal Pyrexia.—Four cases of
puerperal fever were notified during the year. Two cases occurred
in the Chiswick and Ealing Maternity Hospital, one in a private
nursing home, and one in a local general hospital. The case-rate
for Ealing is 2.2 per thousand total births which is well below
the case-rate of 3.3 for England and Wales.
The number of cases of puerperal pyrexia notified during the
year was 21, this showing a slight increase on the 18 cases notified
in the previous year. Nine cases were notified from the Maternity
Hospital, five from private nursing homes and six from private
practitioners. The case-rate for Ealing is 11.4 per thousand
total births compared with 8.5 for England and Wales. Too much
significance must not be placed on the higher rate for Ealing.
The higher rate may not indicate a higher incidence but a scrupulous
regard for the requirements of the Regulations relating to notification
by the medical practitioners concerned. One case notified
as puerperal pyrexia was diagnosed later as puerperal fever. She
subsequently died of cerebral embolism. Two other cases, not
notified as puerperal fever, died, the one being certified as due to
puerperal pelvic abscess and the other as lobar pneumonia and
puerperal septicaemia. There were thus three deaths from puerperal
septicaemia, giving a death rate from this condition of 1.6 per
thousand total births.
Primary and Influenzal Pneumonia.—The numbers of
cases of primary pneumonia and influenzal pneumonia notified
during the year were 85 and 50 respectively compared with 96