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In 158 of the cases the patients were children attending school and in 138 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 161 other cases, although the patients themselves were not school.
going children, there were other children in the houses who were. In 27 instances
the histories showed that there had been cases of "sore throat" amongst the inmates
of the houses in which the patients resided. In 30 instances there was evidence
pointing to infection from previous cases in the Borough. In 271 instances the
houses were occupied by members of more than one family, in 69 by single families,
and in 24 instances the cases occurred in artisans' dwellings of the block type.
With regard to the sanitary condition of the dwellings, in 205 this was satisfactory,
in 77 fairly so, and in 82 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 ; their significance has been referred to in previous reports.
The cases certified as diphtheria in the Metropolis numbered 10,765, the attack
rate being 2.3 per 1,000. The deaths numbered 571 and the death.rate was 0.12
per 1,000 population, the case.mortality being 5 3 per cent.
ENTERIC FEVER.
Four cases were notified which give an attack rate of only 003 per 1,000
population. One of them terminated fatally.
The particulars with regard to the cases are briefly as follows:—Towards the
middle of October, 1923, Doris H-, aged 10, was taken ill with a " cold " at