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of more labour to carry out the work, but in order to prevent loss
of life and injury to health caused by this illness, it should receive
your careful consideration.
The reinstatement (the time for which it was placed on the
list expired during the year) of this illness, Measles, on the list of
notifiable diseases has been a wise course to adopt, and it is certain
this course, if it does not appear to have answered as satisfactorily
as you could have wished, has been the means of parents looking
upon Measles as a more serious disease than hitherto, and so taking
greater care with the children. The same remarks apply to
Whooping Cough, which although not yet placed on the list of
notifiable diseases, I trust will receive the same wise consideration
from you as Measles has, and before long will become compulsorily
notifiable. Although the serious attention of parents was called
to the dangerous and infectious nature of this illness in my fortnightly
reports, abstracts of which were printed by you in the Press
circulating in the District, I am sorry to say little notice was
taken, and the illness spread. The re-opening of schools was
delayed on account of this illness. Measles and Whooping
Cough were both very prevalent throughout the North of London
during the year.
With regard to the other preventable diseases dependent more
directly on sanitary defects of dwellings, such as Typhoid Fever,
Scarlet Fever, Diphtheria, Puerperal Fever, Diarrhœa and
Erysipelas, statistics show that with exception of Diphtheria, the
other diseases were somewhat less in number than previous years.
The Zymotic death rate of 1.5 is somewhat high. This may be
accounted for by the number of deaths from Whooping Cough
and Measles, such mortality affecting the District on account of the
inhabitants of District consisting of young married persons
with young children, who are particularly susceptible to
these diseases. The death rate last year was 0.9; the death rate
for the whole of England and Wales was 2.1 per 1,000.
The death rate from the list of notifiable diseases was 0.7 per
1,000.
The general death rate of 8.5 is extremely low and would
appear to be fallacious if it were not for what has been stated
previously—the neighbourhood at present consists of selected lives,
although on the other hand this low death rate taken in conjunction
with the somewhat high birth rate, the low death rate from Diarrhoea
and Fevers(excluding Measles and WhoopingCough)together with the
small infantile mortality tends to show that good sanitary measures
such as good system of sewers, sewage disposal works, pure water
supply, good scavenging and removal of dust, improved roads,
energetic inspection of houses, combined with decisive action for
sanitary condition such as the substitution of dry basements improved
for wet sites, the proper disconnection of house-drains from sewers,