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both to Enfield. The parents wished to keep one at home and remove the
other. This I hesitated to sanction, as the case left at home would be a centre
of infection to others. Some trouble was caused by this action of the parents,
as the mother was about to be confined, and your Council desired to do all that
was possible to prevent danger to the mother's life. Five cases occurred in the
Central Ward; these children attended either the same Church or School.
Fortunately, by prompt action and co-operation of the School Manager and
Sunday School Superintendent, the illness was prevented from spreading. The
cases were isolated. Two removed to hospital, and the sanitary state of school
overhauled and put right. Scarlet fever was prevalent in London throughout
the whole year. One death from this illness was registered, viz., an inmate of
the Lunatic Asylum.
Erysipelas.
Eleven notifications relating to this illness were received. In the Asylum
probably the general state of health of the insane may have a predisposing
tendency to this illness.
Measles.
The seasonal peculiarity of this illness is well shown in your district. The
illness appeared in April and May, 1895, then disappeared to again show itself
in December, 1895. The northern suburbs of London seem to have been
subject to a wide epidemic of measles. This illness occurs now and then in
epidemics of large extent. Now that measles has been added to the list of
notifiable diseases, your Council is better supplied with the knowledge as to
the prevailing illness in your district. This certainly is an advantage. In
all cases notified, visits are made to the houses, and instructions left to isolate
cases. Unfortunately measles, unlike some other infectious diseases, is infectious
during the stage immediately preceding the appearance of the rash, and as about
twelve days elapse between the exposure to a case and development of disease,
it is not unusual during this period for the illness to be disseminated. The
practical course to adopt on account of this peculiarity of measles is to isolate
a child who has been exposed to the contagion for at least 14 days, since
measles is chiefly infectious through the breath.
Diphtheria.
Four cases were notified in the early part of the year, and were the remains
of a series of cases reported upon in my last Annual Report.
Typhoid Fever.
An isolated case was reported from the Asylum. It was not possible to
trace the cause in this case. Five cases occurred in the South Ward, in that
part known as The Avenue. The first was that of a child, who had eaten
ice-creams, and it was thought probable that this illness may have been contracted
through this cause. A woman and two children probably contracted the illness
through want of care in nursing the first case. Arrangements were made to remove
the cases to a general Hospital. The ambulance from Barnet was used to remove
them. The premises were disinfected, and sanitary defects ordered to be
remedied. The sewers and house drains were flushed with carbolic; cisterns
cleansed. An old sewer was examined and found faulty, and later on connections
were made with new sewer.
In two cases in the Central Ward the illness occurred in adjoining houses.
The drain of one house joined under the kitchen with the other house and
passed to sewer under the house. The drain was in direct communication
with the sewer. No intercepting trap existed. The pipes were laid on the