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Enteric Fever.
One case of Paratyphoid Fever B was admitted during the year. The disease ran a moderate
course and there were no complications.
Erysipelas.
Sixty-one cases of this disease were treated during the year. This number is considerably
above the average. Three deaths occurred.
Measles.
An epidemic of measles occurred in the district during the spring months and 143 cases of this
disease were treated in hospital. In a considerable number of these patients the disease was of a
toxic type and 16 deaths occurred. The causes of death in the fatal cases were as follows:—
Broncho-Pneumonia 13 cases.
Toxaemia 2 „
Cancrum Oris 1 „
The following table illustrates the fact that measles is more dangerous in children under 5
years of age than in those who are over that age. It follows therefore that the longer a child can be
guarded against an attack the less chance there is of the disease proving fatal.

Number of cases under 5 years of age 93
Number of deaths under 5 years of age 14
Case mortality 15%
Number of cases over 5 years of age 50
Number of deaths over 5 years of age 2
Case mortality 4%
Chief Complications.
Broncho-Penumonia 48
Otitis Media 22
Laryngitis 6
Enteritis 5
Cancrum Oris 1
Convalescent Measles Serum.
I am pleased to report that during 1934 arrangements were made whereby a limited supply of
convalescent measles serum was made available for use in suitable circumstances.
Practically everybody resident in this country is attacked by measles at some period of his or
her life, and should the individual be an older child or young adult the consequences are not at all
likely to be serious. It is a different matter, however, when a child afflicted with some other disease
is exposed to infection. During an epidemic of measles patients incubating this disease and suffering
from some other complaint are almost certain to be admitted to hospital with subsequent risk to the
susceptible children in the ward. The serum was employed on four occasions in these circumstances
in the scarlet fever wards of the hospital. Twenty susceptible children who had been exposed to
infection were injected with a suitable dose of serum during the first five days of the incubation period
and complete protection was obtained in all but one case. The latter developed an attenuated attack
in which the rash was scanty and the catarrhal symptoms and pyrexia absent.
The donors ought to be healthy young adults, and no difficulty was experienced in obtaining
suitable patients to act in this capacity. The blood is collected in a special apparatus and dispatched
to the London County Council Laboratory at Hither Green where it is tested and refined and subsequently
supplied in ampoules of 5 c.c. and 10 c.c. capacity. A total amount of 900 c.c. of serum
was obtained from 7 donors.
Mixed Infections.
Scarlet Fever and Mumps 3
Scarlet Fever and Diphtheria 2
Scarlet Fever and Whooping Cough 2
Scarlet Fever and Chicken Pox 1
Scarlet Fever and Measles 1
Measles and Whooping Cough 1
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