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53
" Diagnosis of Diphtheria.
When it is suspected, on clinical grounds, that a child may be
suffering from diphtheria, it is a wise precaution to treat the case as
one of diphtheria without waiting for bacteriological confirmation
of the diagnosis. A negative result to a culture made from a single
swabbing does not exclude a diagnosis of diphtheria since so many
factors may prevent the discovery of the specific organism. The
patient's chance of recovery is greatly increased when diphtheria
anti-toxin is administered in the earliest stages of the disease, while
unnecessary delay may endanger the patient's life. No harm can
result if the injection is subsequently proved to have been unnecessary.
When the parents are in poor circumstances a free supply of diphtheria
anti-toxin may be obtained from the Public Health Department,
Town Hall, Ealing."
During the year under review 252,000 units were supplied
for 29 cases.
Scarlet Fever.—The number of cases of scarlet fever notified
during the year under review was 476, an increase of 69 on the
total of 407 cases occurring in 1932. The scarlet fever case-rate
for the Borough of 3.70 per thousand of population is again above
the rate for England and Wales, which is 3.21. Table VI indicates
the months of the year in which the cases occurred and shows
that the disease continued prevalent throughout the whole twelve
months. December, with 65 cases, showed the greatest prevalence,
while August, with 22 cases, was the only month in which the
average number ot cases was less than one per day.
Unfortunately there were seven deaths from the disease.
One occurred while the patient was being nursed at home, the
second occurred in an institution outside the district, while the
remaining five occurred in the Chiswick and Ealing Isolation
Hospital. The death-rate from scarlet fever for Ealing of 0.05
per thousand of population is above that for England and
Wales, which is 0.02.
Although the number of cases notified during the year under
review was high the prevalence of cases was less than in 1921
and 1922 when scarlet fever previously reached epidemic proportions.
If the disease had been as widespread as in 1921 and 1922, with
the increased population one might have had to contend with as
many as a thousand cases in a year. The number of cases at the
end of the year showed no signs of diminishing, in fact, in the first
four months of 1934 the number of notifications increased by
almost 50 per cent, compared with the corresponding period of
1933.