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36
III. INFECTIOUS AND OTHER DISEASES
During the year 1938 the number of notifications of all infectious diseases (excluding
tuberculosis) was 1,247, as compared with 754 for the year 1937. The deaths
from notifiable diseases (excluding tuberculosis) during 1938 numbered 97, which
figure represents 10.6 per cent, of the total deaths for the Borough. The corresponding
number for 1937 was 104 (10.1 per cent, of the total deaths). The increase in the total
number of notifications was due mainly to the high incidence of measles. Full
particulars of the notified cases, classified according to the time of occurrence,
age, and the wards in which they occurred, are given in Table No. 27.
During the year there was an outbreak of typhoid fever, which is further reported
on page 44. The other diseases of importance, in which a moderate incidence
was shown, were scarlet fever and diphtheria. Examination of Table 27 will indicate
that diphtheria showed no definite seasonal prevalence, but that the number of
cases of scarlet fever, as is generally the case, was higher in the last quarter. As
was the case during both the previous years, the disease continued to be a mild
one ; one death occurred from this cause during the year.
Of the 203 notified cases of diphtheria the diagnosis was subsequently revised
in respect of 61, so that the total accepted cases for the year was 142—which gives a
true attack rate of 1.77 per 1,000 of the population. The number of deaths in these
diphtheria cases was 4, which gives a death rate of 0.05 per 1,000 and a case mortality
rate of 2.82 per cent., compared with a case mortality of 2.40 per cent, for 1937.
Of the 203 patients, 14 (6.9 per cent.) were over the age of 25 years.
A noteworthy feature of the history of infectious diseases in various areas during
recent years is the prominence achieved by dysentery bacilli of the Sonne type.
Although the organism has long been known it was only in 1926 that the first outbreak
of an illness due to this cause was described. Nowadays the disease appears
to be almost endemic in certain areas. During the year 1938, 81 cases occurred in
Shoreditch. A further discussion of these cases appears on page 47.
Attention should be directed to the fact that in 12.68 per cent, of the notified cases
of scarlet fever and in 30.05 per cent, of the notified cases of diphtheria the diagnosis
was subsequently altered. These percentages may appear to be high, but it should
be remembered that the London County Council requires every case to be certified as
suffering from one of the notifiable diseases before the Council will remove the patient
to one of its infectious hospitals. The result is that the weekly figures of notifications
are unduly swollen by the inclusion of patients who obviously require observation in
hospital, but who are possibly not suffering from one of the notifiable diseases. It
should be noted that during the year 68.6 per cent, of all notified cases of infectious
disease were removed to hospital. When measles and whooping cough cases are
left out of consideration this figure becomes 92 per cent.