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19
have been quite unaware of the nature of the disease, and the children were thought
to have had " colds." In a few instances children with scarlet fever were found attending
school, and there is no doubt that the schools played an important part in spreading
the disease. This point is touched upon later in the report (page 19).
The first signs of an undue prevalence of scarlet fever in the Borough made their
appearance towards the end of February. Through March, April and the first half of
May the weekly numbers of cases certified remained above the average. They then rose
rapidly with one or two intermissions reaching a maximum in the first week of July,
after which they declined gradually, though still remaining much above the average.
In the first week in September there was another abrupt rise in the number of cases
and a second maximum, higher than the first, was reached in the middle fortnight
of September, during which period some 72 cases were certified. Through October,
November and December there was a gradual fall in the number of cases until the end
of the year, when the signs of undue prevalence were no longer apparent in the
Borough. During the last quarter of the year, however, the weekly numbers of cases
certified were markedly above the average.
The cases certified were at the rate of 6.7 per 1,000 inhabitants, as compared
with 2.9 in 1904, 2.1 in 1903, 2.1 in 1902, 4.7 in 1901, and 2.7 in 1900. The
cases were most numerous and the attack-rates highest in Hoxton and Wenlock Wards
and lowest in Moorfields, the rates being 9.6 and 8.2 respectively in the former, and
2.5 per 1,000 in the latter. The deaths numbered 27, as compared with 13 during
1904, and the death-rate due to the disease was 0.23 per 1,000, as compared with
0.11 in 1904, 0.05 in 1903, 0.06 in 1902, and 0.17 in 1901. The case-mortality was at
the rate of 3.4 per cent. of the cases certified, as compared with 3.8 in 1904, 2.7 in
1903, 3.3 in 1902, 3.5 in 1901, 5.4 in 1900, 4.1 in 1899, 4.7 in 1898, 4.9 in
1897, and 5.4 in 1896. Amongst children under five years of age there were 286 cases
with 22 deaths, the mortality being 7.7 per cent. (or allowing for cases not regarded
as scarlet fever at the hospitals, 8 per cent.), as compared with 7.8 in 1904, 2.7 in
1903, 5.3 in 1902, 6.8 in 1901, 12 in 1900, and 9.1 in 1899. Among persons aged
five years and upwards there were 503 cases with 5 deaths, the mortality being barely
1 per cent. (allowing for cases not regarded as scarlet fever, just over 1 per cent.), as
compared with 1.8 per cent. in 1904, 2.7 in 1903, 2 in 1902, and 1.7 in 1901.
The cases of scarlet fever certified in the metropolis during 1904 numbered
19,460, or about 6.000 more than in 1904, the attack-rate being 4.1 per 1,000 inhabitants,
as compared with 2.8 in 1904, 2.7 in 1903, 3.9 in 1902, 4.4 in 1901, 3.0 in 1900,
and 3.9 in 1899. Comparing these with the Shoreditch attack-rates given above, it is
evident that scarlet fever was unusually prevalent in Shoreditch during 1905.
The deaths from scarlet fever in London numbered 549, as compared with 365
in 1904, 361 in 1903, 560 in 1902, 584 in 1901, and 361 in 1900, the death-rate being
0.11 per 1,000', as compared with 0.08 in 1904, 0.07 in 1903, 0.12 in 1902, 0.13 in
1901, and 0.08 in 1900,