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There was an outbreak of moderate severity in june end July,
from October to Christmas it was very prevalent and of a severs
type. Pneumonia was present in a considerable number of cases,
(1) of the lobar type, (2) "Septic" with death following within a
few hours of onset almost invariably. There was a great shortage
of doctors to cope with the epidemic in the district. Of the six
resident normally, two were in the Army, one was seriously ill,
and two "locume" were incapacitated by the disease. The remaining
three were too overworked to do any pathologioal or other investigations
into the cause and nature of the disease. It is estimated
that there were about 4,000 cases, including mild ones, though no
actual figures are available, A post-mortem was done in one case,
in which the lungs were found to consist of scattered patches of
solid lung with generalised purluent bronchitis. There was no
evidence on the means of introduction of the disease, though it was
definitely transmitted by close contact. The period of incubation
was short, probably two or three days only. Infectivity appeared
to cease with subsidence of fever. Previous attacks did not appear
to give protection, The disease started amongst school-children,
was very prevalent and more severe amongst healthy young adults and
was almost entirely absent amongst elderly, weakly people.
Advice and warnings were published in the local Press, All
day and Sunday-schools were closed, and the Cinema was closed at
short intervals for ventilation and disinfection. The only hospital
treatment available was the Workhouse Infirmary. It is doubtful if
any scheme of hospital treatment could have dealt with so large a
number of cases. As was to be expeoted, there was a great shortage
of nurses. Vaccine treatment was attempted in several cases with
doubtful success.
Measles.
it is noteworthy that only 35 oases of lieasles, with no deaths
occurred, as against 198, with 2 deaths, in 1917.
Troops.
Very few troops have been billeted in the district. The new
Workhouse Infirmary has been used as a Military Hospital, and the
Ewen Hall, Wood Street, as a V.A.D. Hospital, with 70 beds.
Maternity & Child Welfare.
"A dent re has been carried on during the year at the
Church House. The work is growin; steaaily. 172 children under 5
attended in 1918, with a total number of attendances of 1,049, as
against 586 in 1917. There was only one death amongst these children.
The mothers attend very regularly, and the weekly number of
children who are brought varies from 30 - 40.
Practically no ante-natal work has been done during the year,
There is no suitable accommodation for this and the local midwifes
do not appear to be interested in the Maternity Welfare Work, Dr,
Swatman of the Herts, County Council is in charge.
Small-pox Accommodation.
Small-pox accommodation has been provided at Cheshunt.
Housing.
It has not been possible for the Council tr deal with the
unsatisfactory Housing conditions existing in parts of the district,
although attention has repeatedly been called to various property
by the Sanitary Inspector and myself.
Overcrowding has been taking place with its resultant bad
effects. As soon as suitable accommodation can be provided several
houses will have to be closed. It is anticipated that the
passing of a new Housing Bill will enable local authorities to deal
more stringently with this important question rnd that it will be
incumbent upon authorities to provide adequate housing accommodation
to meet the needs of the District.
The present Estato is to be developed further, witty 8 houses to
the acre. 113 new houses are to be added to the existing 5£. This
matter is receiving the most urgent and constant attention of the
Council.
I am
'Yours faithfully,
CHAS.F. HARDI M,A, M,,B, B.O.
Hedi Officer of Health. Cantab,