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circumstances I would suggest that where the clinical signs give good reason to believe that the case
is one of Diphtheria, arrangements be made with Dr. Stewart for the admission of the case, if possible,
to Hospital (Telephone No. Willesden 1849), for observation and early treatment as may be
necessary. Too much reliance should not be placed on bacteriological diagnosis when the clinical
evidence points to Diphtheria.
George F. Buchan,
Medical Officer of Health.
Enteric Fever.—During the year 5 cases were notified, and 2 of these were removed to
Hospital. The incidence rate per 1,000 of the population is 0.03. There were no deaths.
Encephalitis Lethargica and Acute Polio Encephalitis became notifiable on January
1st January, 1919. Three cases of Encephalitis Lethargica were notified during the year.
The first was a man of 60 years notified on June 19th. He was removed to the Municipal
Hospital, where the initial diagnosis was altered to "a cerebral condition which is yielding to antisyphilitic
treatment." The patient was discharged much improved.
The second was a girl of 13 years, notified on November 11th. She was removed to St. Mary's
Hospital, and was still attending as an out-patient at the end of the year.
The third was a boy of 15 years, notified on December 12th. He was removed to St. George's
Hospital, from which he was discharged in February, 1920, convalescent, under the care of his private
doctor.
There does not appear to have been any connection between the cases.
One case of Acute Polio-Encephalitis was notified during the year.
It occurred in a man of 23 years, and was fatal when notified, death having occurred three
days after onset.
The case was nursed at home, being in one of the best class houses in the district. Lumber
puncture was not done, nor was any post mortem examination made.
Poliomyelitis.—Three cases were notified during the year.
One case, a child of l10/12 years, was removed to the Municipal Hospital and recovered,
but with loss of power in both legs.
The other two cases, one a child, aged 3 years, and the other a child, aged 14 years, were
nursed at home, and both recovered. The child of 3 years was still attending Maida Vale Hospital
at the end of the year for paralysis of legs, and was reported improving.
Cerebro-Spinal Meningitis.—Three cases were notified during the year. Two were treated
in the Municipal Hospital, and one in Great Ormond Street Hospital. All recovered.
Of the two cases removed to the Municipal Hospital, one occurring in a man of 22 years was
not diagnosed clinically as cerebro-spinal meningitis in Hospital, and a swab taken was negative,
the condition being diagnosed as cephalalgia and constipation. The other case, occurring in a child
of 2 years, was diagnosed in Hospital as gastritis. The case removed to Great Ormond Street
Hospital, a child of 8 months, was also discharged well—no paralysis.
Pneumonia, Malaria, Dysentery and Trench Fever became notifiable on March 1st, 1919.
Pneumonia.—Eighty-eight cases were notified, the greatest number, 37, occurring between
the ages of 25 and 45.
The wards with the greatest number of notifications were South Kilburn and Mid-Kilburn,
with 15 and 17 respectively as against an average of 6 in the other wards.
The notifications were highest during the 4 weeks ended 22nd March, 1919, and the 4 weeks
ended 19th April, 1919, being 27 and 18 respectively. With these exceptions, the notifications did
not rise above 8 in any of the 4 weekly periods.
Five of the 88 cases notified were removed to the Municipal Hospital.
Of the 88 cases notified, 29 died.
Out of 84 of the notified cases in which information is available, 48 were nursed at home and
36 were removed to hospitals—5 to the Municipal Hospital, 10 to Hospitals outside Willesden, and
21 to the Willesden Infirmary.
Of the 48 nursed at home, 16 died, or 33.4 per cent.
Of the 36 removed to hospitals, 13 died, or 36.1 per cent., 1 death occurring in the Municipal
Hospital, 3 in hospitals outside Willesden, and 9 in the Willesden Infirmary.