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4.4 in 1901, 3.0 in 1900, 3.9 in 1899, 3.7 in 1898, 5.1 in 1897, and 5.8 in 1896. With
respect to the incidence of scarlet fever attacks Shoreditch does not compare
unfavourably with the Metropolis as a whole, which must be regarded as satisfactory
considering the density with which the Borough is populated. Taking the six years,
1896-1901, for which the complete figures are available, the average attack-rate per
1,000 inhabitants for Shoreditch was 4.1; for the whole Metropolis during the same
period it was 4.3. The percentage of the cases notified removed to hospital during
this period in Shoreditch and London were 81 and 72 respectively. It is possible that
in this difference in the percentages of removals lies the reason why the incidence of
scarlet fever in Shoreditch, which is about three times as thickly populated as the
Metropolis taken as a whole, is only about the same as the average for London.
The deaths from scarlet fever in London numbered 361, as compared with 560 in
1902, 584 in 1901 and 361 in 1900, the death-rate being 0.07 per 1,000, as compared
with 0.12 in 1902, 3 13 in 1901, 0.08 in 1900, 0.09 in 1899, and 0.13 in 1898.
DIPHTHERIA (INCLUDING MEMBRANOUS CROUP).
The cases certified numbered 154, including 13 which were subsequently stated
not to be cases of diphtheria by the authorities of the Metropolitan Asylums Board.
The eases were fewer in number than in any year since the notification of infectious
disease became compulsory. The deaths numbered 21 and the death-rate was 0.18
per 1,000, as compared with 0.18 in 1902, 0.23 in 1901, 0.45 in 1900, and 0.52 in 1899
(appendix Table VI). The attacks during 1903 were somewhat more fatal than in
1902, the mortality being 13.6 percent. of the cases certified (14.9 allowing for the
cases not regarded as diphtheria at the fever hospitals), as compared with 10.7 percent.
in 1902. The case mortalities for previous years were, 8.8 in 1901, 15.3 in 1900,
17.0 in 1899, 17 3 in 1898, 22.1 in 1897, 21.0 in 1896, 24.1 in 1895, 24.0 in 1894, and
29.0 in 1893. The whole of the deaths during 1903 were of children under the age
of 5 years, and the mortality amongst them amounted to 23.8 percent. of the cases
certified (256 percent. allowing for the cases not regarded as diphtheria by
Hospital Authorities), as compared with 20.5 percent. in 1902, 15.4 in 1901, 22 7 in
1900, 34.2 in 1899, 29.5 in 1898, 36.0 in 1897, 31 8 in 1896, 47.5 in 1895, 43.0 in 1894
and 61.0 in 1893. The figures for the last two years, 1902-03, indicate that whilst the
cases of diphtheria have become fewer the severity of the attacks has somewhat
increased. The disease however is far from being the fatal disorder it was 10 years
ago.