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60
SECTION F— PREVALENCE OF, AND CONTROL
OVER, INFECTIOUS AND OTHER DISEASES.
Tables IX, IXa X and XI in the Appendix give
statistical data in connection with notifications of infectious
disease and tuberculosis during 1938.
Scarlet Fever.
The incidence of Scarlet Fever continued at a low
level and we are in the trough of the periodic wave.
There was a further reduction in the incidence rate
from 1.7 to 1.19.
Scarlet Fever to-day can be looked upon as a variety
of infections and not as a single disease. The varieties
of the infecting germ are multiple in type, and consequent
signs are not always to type. This further complicates
the question of hospital admission previously
discussed in my annual reports and further strengthens
the policy of home isolation. In spite of this, 57 of the
71 notified cases were admitted for hospital treatment,
i.e., 80 per cent. of cases as compared with 83 per cent.
in the previous year. Cases should only be admitted to
hospital if they cannot be satisfactorily nursed at home
or if the severity of the infection warrants hospital
treatment. The cost of hospital treatment is a high
one for Bromley.
Diphtheria.
A marked fall in the incidence of diphtheria is
again reported—19 cases compared with 40 of the previous
year; and incidence rate of .32 as compared with
.6 for 1937. There were no deaths.
Diphtheria immunisation is progressive, but I am
not yet prepared to say that the control of the infection
is due entirely to this. I can say, at this stage, that
immunisation is of immense value and a great help in
the investigation and control of an outbreak of infection
in schools.