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The death-rate was 0.77 per 1,000 inhabitants, compared with 2.93 in
1918. Besides, there were 20 deaths amongst non-residents in the Infirmary,
none in the Epileptic Colony, and 14 amongst the military.
In March I reported that this disease was much in evidence again. During
the four weeks ended February 22nd, there were 17 deaths, compared with 6 for
the previous four weeks. The new outbreak presented similar characteristics
to the last one, i.e., it was most fatal between the ages of 18 and 45, and the
secondary cause of death was usually pneumonia.
The Local Government Board sent a specimen leaflet of advice, dated
February, 1919, similar to the one issued in November, 1918, 7,000 of which
were distributed. The Board also sent a memorandum on the prevention of
influenza, containing directions as to the action to be taken by the Authority.
Under the Pneumonia, etc., Regulations, which came into force on the
1st March, 17 cases of pneumonia following influenza were notified during the
five weeks ending 29th March. None were removed to our Hospital. The
deaths among residents from influenza number 20 for the same period; there
were 17 for the previous four weeks.
In a circular of the Local Government Board of the 13th March I was
instructed to forward each week a separate return, on a card provided by the
Board, of the number of deaths registered weekly as due to influenza, beginning
with the week ending 22nd March.
In a letter of the 28th March, from the Joint Hospital Board, it was
announced:—
"That the Board, at their meeting yesterday, decided to set apart one of
the blocks at their hospital for the reception of cases of malaria, dysentery,
trench fever, and such cases of pneumonia as are contemplated on Page 5 of
the memorandum of the Local Government Board, dated January, 1919, on
the understanding that each case is recommended by the Medical Officer of
Health of one of the constituent districts," of Enfield and Edmonton.
The deaths amongst residents for the four weeks ending 26th April were
only five, compared with 20 for the previous five weeks, so that the third wave
of this disease since last July appeared to have spent its force. There were
five cases of influenzal pneumonia in five houses.
There were only two deaths from influenza amongst the residents of Edmonton
for the four weeks ending May 24th. By an Order of the 6th May, the
Local Government Board rescinded the Public Health (Influenza) Regulations,
1918, both sets, so that the power of Local Authorities over picture palaces is
withdrawn.
On the 23rd December the Medical Officer received from the Ministry of
Health a circular letter, dated the 20th, accompanied by a memorandum on