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Vaccination.—The number of primary vaccinations for the
year is approximately 1,120, as compared with 1,891 registered
births. The percentage yielded by these figures (59) is considerably
lower than it ought to be and its continuance in future would point
to a dangerous proportion of our population growing up unprotected
from the disease and ready to play the part of matchwood to the
sparks, in the form of imported cases, to which, as we have seen,
this district is so liable.
Scarlet Fever. 181 notifications were received during the
year, giving an attack rate of 3.3 per 1,000 of the population. The
cases were distributed among 133 houses and 66 streets. One case
occurred in 103 houses, 2 cases in 14 houses, 3 in 9 houses, and
4 in 6 houses. The removals to hospital numbered 132—an
isolation percentage of 72.9 per cent. There were 3 deaths, giving
a fatality of 1.6 per cent: and a death rate of 0.05 per 1,000. The
chief feature that marked the disease throughout the year was the
number of cases that were overlooked or mistaken by the parents
for complaints of a minor nature, such as simple sore throat, cold,
and, less frequently, measles. On several occasions the medical
attendant, on being called in to see a patient, has found another child
of the family in the peeling stage, having evidently passed through
the acute stage of the illness without attracting special notice.
There is little doubt that in this way the number of scarlet fever
cases was increased beyond the extent that its mildness, as judged
by the low case mortality, and its consequently lessened infectivity,
would account for. That the infectivity of the general run of the
milder cases has been low, or of greatly shortened duration, is shown
by the fact that many of these children, the nature of whose illness
had been overlooked, attended school regularly, except perhaps for
two or three days spent at home on account of the supposed simple
sore throat or cold—in reality the scarlatinal onset—without communicating
the disease to any of their schoolfellows. The closer
intercourse of the home, however, was not proof against even a low
degree of infectivity and the original case was, in the end, brought
to light by the subsequent occurrence of the disease amongst his
brothers and sisters.