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In 62 of the cases the patients were children attending school, and in 52 of these
they were at school within a week of being certified as having the disease. As noted
in previous years, there were instances in which the children were at school whilst
suffering from diphtheria, before the nature of their illness was recognised. In
45 other cases, although the patients themselves were not school-going children,
there were other children in the houses who were. In 8 instances the histories
showed that there had been cases of "sore throat" amongst the inmates of the
houses in which the patients resided. In 9 instances there was evidence pointing
to infection from previous cases in the Borough. In 86 instances the houses were
occupied by members of more than one family, in 32 by single families, and in
8 instances the cases occurred in artisan's dwellings of the block type. With regard
to the sanitary condition of the dwellings, in 85 this was satisfactory, in 16 fairly so,
and in 25 it was unsatisfactory, but these figures must not be taken as an indication
that a satisfactory sanitary condition is favourable to the occurrence of diphtheria
in houses. Similar proportions have been obtained in inspecting houses in which
no diphtheria cases were notified.
The cases certified as diphtheria in London numbered 7,109, as compared with
7,378 in 1911, 5,508 in 1910, 6,783 in 1909, 7,840 in 1908 and 8,585 in 1907, the
attack-rates being 1.5, 1.6, 1.1, 1.4, 1.6 and 1.8 per 1,000 population for the
6 years respectively. The deaths from the disease in the Metropolis numbered 452
as compared with 612 in 1911, 434 in 1910, 605 in 1909 and 724 in 1908, the deathrate
for the five years respectively being 0.10, 0.11, 0.09, 0.12 and 0.15 per 1,000
population.
ENTERIC OR TYPHOID FEVER.
The cases numbered 14 as certified, but 2 were subsequently not regarded as
cases of enteric fever at the hospitals to which they were removed, and a third which
was not removed to hospital was probably not a case of enteric fever.