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20
Erysipelas.
401 cases were notified, or 45 more than in the previous year.
62 occurred in the Limehouse District, with 3 deaths;
87 occurred in St. George-in-the-East, with 1 death;
127 occurred in Mile End Old Town, with 3 deaths;
125 occurred in the Whitechapel District, with 2 deaths.
Puerperal Fever.
33 cases of Puerperal Fever were notified, the same number as in the previous
year.
9 occurred in the Limehouse District, with 2 deaths;
4 occurred in St. George-in-the-East, with 2 deaths;
14 occurred in Mile End Old Town, with 8 deaths;
6 occurred in the Whitechapel District, with 1 death.
Cerebro-Spinal Fever.
Cerebro-spinal Fever (known also as Epidemic Cerebro-spinal Meningitis and
Spotted Fever) has recently attracted a great deal of attention, due to the fact,
probably, that it has made its appearance among the Troops. It is an acute epidemic
disease, characterised by great disturbance of the central nervous system, indicated
at the outset chiefly by shivering, intense headache or vertigo, or both, and persistent
vomiting. There is acute pain in certain muscles, especially the posterior muscles
of the neck, occasioning retraction of the head.
The organism which causes the disease is found in the mucous secretion of the
naso-pharynx in a considerable proportion of those suffering, especially in its earlier
stages. It is also found in some apparently healthy persons, who have been in contact
with those suffering from the disease. Many people who thus harbour the organism
(meningo-coccus) in their naso-pharynx, may either remain unaffected, or suffer only
from a slight pharyngeal catarrh, but they may transmit the disease to others. This
is especially likely to happen when there is intimate contact, such as occurs in the
fondling of children or in kissing.
Outbreaks are usually associated with overcrowding of civil or military populations.
The spread of the disease is usually associated also with lack of cleanliness,
and ventilation, and frequently with inclement conditions of weather. Under such
circumstances, it appears likely that the resistance to infection is lowered, the opportunities
for infection are increased, and that possibly the virulence of the meningococcus
is greater.
Four cases were notified during the year, one having occurred in the Limehouse
district, two in St. George's and one in Whitechapel. All proved fatal.