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64
(3) Although Scarlet Fever has a decreasing
mortality during the past thirty years, there has been no
diminution of prevalence.
The report of the Committee on Local Expenditure
issued in 1932, page 89, states " There is no reason for
prescribing a routine period of detention in hospital of
more than four weeks in uncomplicated cases of Scarlet
Fever . . . nothing to suggest an extension of the routine
period of detention lias any effect on the number of return
cases or on the incidence of, or mortality from, the disease.
We think that the saving to be secured by adoption of the
conclusion—would be of the order of £120,000 per
annum." " Careful consideration should also be given to
the question whether mild cases of scarlet fever might not
be dealt with at home."
Diphtheria.
The anticipated rise in incidence of diphtheria occurred
in 1934—43 cases, giving a rate of 0.8 per thousand
population. There were two deaths, equivalent to 4.6 per
cent, of cases notified. One case was home nursed. A
practical step in the prevention of diphtheria epidemic
lies in the immunisation of the pre-school child, but to
date, although the immunisation clinic has been
established since 1928 we have not reached 30 per cent, of
immunised children. A minority of parents have
responded to the request for immunisation, but it requires
a serious epidemic to rouse public opinion to the advantages
of this method of prevention. Immunisation during
epidemic times, is, in practice, almost valueless, as it takes
at least three months to create an immunity. It is during
non-epidemic times that diphtheria immunisation must be
exercised, especially during the pre-school years.
There were 37 sessions held at the diphtheria immunisation
clinic, and 539 attendances were made during these
sessions. Although the numbers are small it must not be
overlooked that they represent the response of the public
without any propaganda in the matter.
Smallpox.
No cases of smallpox were reported, and no cases
occurred since we experienced the epidemic of 57 mild cases
in 1930.