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54
XIV. INFECTIOUS DISEASES CONTROL.
The outstanding feature of the year 1930 was the
occurrence in Bromley of Smallpox in epidemic form. For
two years we escaped infection, although London had been
for some time suffering from a rather extensive epidemic.
Appendix IX gives the number of cases of all notifiable
diseases together with their Mortality Rate, Incidence
Rate and the number of cases removed to hospital. It will
be seen that compared with the previous year there has
been an increase in Scarlet Fever notification, but a slight
fall in the Diphtheria Rate. It would appear from the
charting of these two diseases in Bromley over the past
forty years that the Diphtheria wave closely follows the
Scarlet Fever wave; the apex of the curves being reached
every five years. If the curves follow their usual courses
1930 would appear to be the apex year, although factors
such as emigration and immigration affect the attack
rate, for not only does the attack rate depend upon the
virulence of the infecting organism, but also upon the proportion
of susceptible people present in the community.
Sporadic cases of Typhoid and Cerebro-Spinal infections
appeared during the year, and although Psittacosis
caused some anxiety in England, no case occurred in
Bromley. Glandular Fever appeared in the district, but
did not reach epidemic form. Whooping cough and
measles were low in incidence, but as neither of these diseases
is notifiable, one has no definite statistical evidence
to submit. Influenza was practically negligible, and although
there was an increase in Pneumonia notification,
the deaths from the disease were fewer.
Scarlet Fever.
Although Scarlet Fever in 1930 declined throughout
England and Wales as a whole, Bromley showed an increased
incidence.
The type of infection was mild, causing only
one death, but the prevalence of minor complications
was marked. As a rule a decline in incidence throughout
the country means an increase in virulence of
type, and this might explain Bromley conditions