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11
The cases of scarlet fever certified in London numbered 11,538, being at the
rate of 2.5 per 1,000 population. The deaths numbered 129, which gave a rate of
0.02 per 1,000 population, as estimated for the middle of the year 1923.
DIPHTHERIA (INCLUDING MEMBRANOUS CROUP).
The cases certified numbered 381, of which 92, or 24.1 per cent, were subsequently
not regarded as being diphtheria, a number which is very greatly in excess of the
average for the past 10 years.

The cases are grouped according to ages in Table II. (Appendix). Of the cases
certified 379, or 99.5 per cent., were removed to hospital. The cases were certified
at the rate of 3.6 per 1,000 inhabitants, the rate being the highest in Kingsland
Ward.and lowest in Moorfields, 4.9 and 2.2 per 1,000 respectively.
The deaths numbered 15, the rate being 0.14 per 1,000 population. The rate
was highest in Acton Ward, where it amounted to 0.33 per 1,000. There were no
deaths in Moorfields and Haggerston Wards. Of the cases certified 3.9 per cent.
terminated fatally. Eleven of the deaths were of children under five years of age,
the mortality being at the rate of 6.3 percent. of the cases certified amongst children
at that age period. Allowing for errors in diagnosis, this mortality was increased to
8.1 per cent. Amongst persons over five years of age the mortality was 1.4, or,
allowing for errors in diagnosis, 2.6 per cent. of the cases certified.
During the year some 86,000 units of antitoxin supplied by the Sanitary
Authority were used in fourteen diphtheria cases before removal to hospital.