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47
Diphtheria.—The number of cases of diphtheria notified
during the year was 228, compared with 195 in the previous year.
After eleven years of low incidence of this disease the increased
prevalence in the last two years, which is clearly shown in the
table on page 44, is very noticeable. It must be pointed out,
however, that the total of 228 cases expressed as a case-rate of
1.66 per thousand of population is almost identical with the average
for the whole country, the case-rate for England and Wales being
1.60 per thousand of population.
The distribution of the cases according to age and the numbers
occurring in each Ward are indicated on page 45. It will be seen
that as many as 68 cases occurred in the Manor Ward, an unduly
high proportion, particularly as in the previous year the greatest
incidence occurred in the same ward. Scrutiny of the cases
occurring in this ward shows, however, that only 19 cases occurred
in private houses, that 15 occurred in the King Edward Memorial
Hospital, and that the remaining 34 were children residing in
three Children's Homes which are situated in close proximity to
one another. The outbreak of infection in these Homes entailed
numerous visits by the medical and nursing staff for the examination
and swabbing of contacts and the ultimate immunization of all
the children.
The occurrence of cases throughout the year was as follows :—
Jan. Eeb. Mar. Apr. May June July Aug. Sep. Oct. Nov. Dec.
23 11 14 16 13 10 28 13 37 35 20 8
July, September and October were the months in which
the disease was most prevalent, and of the one hundred cases
which occurred in these months 38 were in the Manor Ward.
The accommodation at the Isolation Hospital for diphtheria
cases was at times, insufficient to deal with the demand for
admission and no less than 51 cases were admitted from the
Borough either to the Acton or to the Willesden Isolation Hospitals.
During the year 15 deaths were recorded, equivalent to a
death-rate of 0.11 per thousand of population and a mortalityrate
of 6.58 per cent, of cases notified, compared with figures of
0.06 and 4.10 respectively, in the previous year. The death-rate
for the Borough was higher than that recorded for England and
Wales of 0.08 per thousand of population.