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i.e. a case of Scarlet Fever which resulted from a child going into the Isolation Hospital with
one variety of Streptococcus and coming out with another. This is quite a good record Most
cases of Scarlet Fever are nowadays fairly mild and many people wonder why in Edmonton rigorous
isolation of cases of contacts continues, whereas in neighbouring areas the disease is treated
much more lightly by the Public Health Department. The answer to these queries is simple enough
the bacteria which cause Scarlet Fever can also cause much more serious diseases Apart from
the so-called Streptococcal sore throat which really amounts to Scarlet Fever without the rash)
and infections of the skin and ear, they can also cause Rheumatic Fever and Nephritis In both
these diseases the first attacks, though uncomfortable for the patient, are not severe but
later attacks cause serious damage to the heart or kidneys as the case may be, In England and
Wales in 1957, 2,359 people died of Nephritis, 174 people of Rheumatic Fever and 8 270 people
of Chronic Rheumatic Heart Disease, If all the Streptococcal infections were grouped together
as Streptococcosis, one could say that nearly 11,000 people died in England and Wales in 1957
from Streptococcosis, Tuberculosis in the same year killed Just under 5,000 people.
Owing to the fact that it is in the late stages of Rheumatic Heart Disease and Nephritis
that death occurs it is difficult to judge the efficacy of control measures.
I have already referred to difference in the death rate from Nephritis in Southgate and
Edmonton Taking the comparison a stage further,, the death rate per 10,000 in England and Wales
was .96, in Scotland 1.07, in Enfield 1. 19, in Southgate 1.5 and in Edmonton. 8.
Whatever the reason, the kidneys are safer in Edmonton than in Enfield or Southgate.
INFLUENZA
In Edmonton the epidemic of Asiatic Influenza was first noticed in the middle of September
in the Halliwick Cripples' Home. Children in the borough's schools started to go down with
Influenza in the same week and by the 27th September about 10 per cent of the school children
were away with Influenza. It is possible that the Halliwick Cripples' Home was the original
focus since the first case there was actually noticed on 10th September, 36 out of 48 children
had been affected by the 23rd. By the first week in October, the absence rate in the schools
as a whole was up to 35 per cent. From then it slowly fell and was about 20 per cent at the end
of the week ending 18th October, By the middle of November it had fallen to 7 per cent.
SUSPECTED DIPHTHERIA
A suspected Diphtheria outbreak was discovered in November On the 11th November a barman
at a local hotel was removed to hospital as a suspected case of Diphtheria. I was informed by
the hospital and arranged for the staff in contact with this man to be examined Subsequently,
the hospital reported that the bacteria found in the throat of the patient closely resembled
C, Diphtheria Mitis but were of very low virulence; the patient was only suffering from a mild
sore throat. After examination of the throat swabs taken from the contacts, the Edmonton Public
Health Laboratory reported that one female member of the staff had a similar bacillus in her
throat,* she was, therefore, also sent to hospital The other members of the staff were advised
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