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35
I am personally of the opinion that admission to hospital
played no part in the prevention of the spread of infection.
Since 1920, 524 cases of scarlet fever have been notified
(being more prevalent in 1921 and 1922 than in the latter
three years), and 4 deaths therefrom.
The type of case during 1925 has continued mild in
nature, and except in two cases were free from complications.
In two instances "return" cases arose in two families; in
one family all four children but one became infected, and
were admitted to hospital.
.
The "Dick" test is not carried out in Bromley, and a
practical policy does not appear to be necessary at present.
Diphtheria.
Eighteen casey were notified during the year, with no
deaths, giving an incidence rate of .4 per 1,000 population,
compared with 1.23 the incidence rate for England and
Wales.
Since 1920, 237 cases have been notified and 7 deaths.
Antitoxin is now on free issue to practitioners, and I
have made it a practice chat no case is admitted to hospital
without 8,000 units of antitoxin having first been administered.
It is essential if we are to prevent deaths in diphtheria
that antitoxin in sufficient doses be administered at the
earliest possible moment. The practice of waiting for swab
results before the adminstration of antitoxin has been distinctly
discouraged; cases should be inoculated pending the
result of the swab.
The modern success that has attended the Schick Routine,
whereby susceptibles are inoculated with a