View report page

22
The cases are grouped according to ages in Table III. (appendix).
The cases certified were at the rate of 1.5 per 1,000 inhabitants as compared with
1.3 in 1903, 2 in 1902, 2.6 in 1901 and 3 in 1900. The cases certified as diphtheria in
the Metropolis numbered 7,079, about five hundred less than in 1903, the rate being 1.5
per 1,000 inhabitants or about the same as that in Shoreditch. The deaths in the
Metropolis numbered 723, the death-rate being 0.16 per 1,000 inhabitants, which is again
the same as that of Shoreditch.
Of the cases certified in the Borough during 1904 slightly over 94 per cent were removed
to hospital for treatment as compared with 88 per cent. in 1903, 84 in 1902, 83
in 1901, 86 in 1900, 80 in 1899, 77 in 1898, 67 in 1897, and 65 in 1896. The increase in
the percentage of removals of cases of diphtheria has not been associated with such a
marked decline in the yearly average number of cases certified as has happened with
respect to scarlet fever as the following figures show:

It is probable that the above figures, however, are somewhat wide of the mark as to
the actual amount of diphtheria prevalent. The disease is not so distinctively marked
as scarlet fever and mild cases may more readily escape detection. Cases not diphtheria
are removed to hospital whilst probably quite as many which are diphtheria are left unrecognised
to spread infection. The following series of cases of throat illness, which
came under observation during the year, may be mentioned as illustrating this:- About
August 1st a girl aged 14 years, residing at No. 45, O- Street, went to stay for a
week with a relative living at Clapton. Whilst there she played with children belonging
to a family, a member of which had been recently removed to hospital with diphtheria.
The girl returned home to O-Street about August 8th, and on August 13th she was
ill with a severe "0sore throat" She appears to have been ill for about three or four
weeks. Between August 13th and October 2nd, besides the patient mentioned, a
brother, her mother, two sisters and then another brother successively developed more or
less severe "sore throats." The last case was that of a brother, a young man; employed
in the General Post Office. He was taken ill with a "sore throat" about
October 2nd. The appearance of his throat seems not to have presented1 the
aspect of diphtheria, l.ut the result of a bacteriological examination was that the bacillus
of diphtheria was present. The case was brought under my notice by the Medical
Officer of the Post Office, with a view to such steps being taken as might be thought
necessary. On October 10th, beyond an appearance of past inflammation, there were no
signs of diphtheria so far as the aspect of the throat went. The necessary precautions
as to isolation were taken pending the result of a second bacteriological examination,