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23
An understanding of these simple and practical measures may
go far to reduce the number of cases.
Puerperal Pyrexia.
This condition is now defined as any febrile condition occurring
in a woman within 21 days of childbirth or miscarriage in which a
temperature of 100.4 deg. F. has been sustained for 24 hours or
has recurred within that period.
Many of these women were suffering from conditions quite
unrelated to the confinement.
Twenty-four cases of puerperal pyrexia occurred, of whom
15 were in Perivale Maternity Hospital, 3 in other hospitals, 2 in
local nursing homes and 4 in the patient's own home.
No deaths were reported during the year; this compares with
2 deaths in 1949, 1 in 1948, and 5 in 1935 (the pre-sulphonamide
days) when 18 cases were notified—a case mortality of 27.7.
Scarlet Fever.
The incidence of infectious diseases varies with the season,
usually being most prevalent in autumn and winter.
Long term changes in the periodicity are also found.
Scarlet fever has a long term cycle of 20-30 years, super"
•mposed on which there is a short term cycle of 4 to 6 years.
With the decline in the incidence there has also been a marked
decline in the virulence of the haemolytic streptococcus which is the
cause of this disease.
At present the disease is manifesting a very mild form. The
records show that over the past 200 years there have been several
periods in which the disease became mild followed by the recurrence
of the more severe form.
It has been suggested that the improved general health and
nutritional state of the children has produced a greater resistance
to the disease.
During the year 286 cases of scarlet fever were notified. This
represents a moderate increase over 1949 when 175 cases were
notified, but only 61 cases were of sufficient severity to require
hospital treatment—the same number as last year.
The incidence rose markedly during the winter months to
7 cases per week as compared to 3 during the summer.