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107
VI.—PREVALENCE OF, AND CONTROL OVER, DISEASE.
A—Notifiable Diseases.
1,750 notifications (other than of tuberculosis) were received, or 687 less
than in the previous year. This is good news, but it is very disappointing to
note that Diphtheria did not share in this decrease. The notification rate
for the whole Borough was 8.1 per 1,000 of the population.
Notifications.
814 cases were notified during the year, or 569 less than in the previous
year. 808 of these cases were removed to hospital. There is little to report;
the disease showed its usual mild form. The death rate for the whole Borough
was .01 per 1,000 of the population. 45 cases were wrongly diagnosed;
there were 4 deaths, all in children under 5 years of age; the case mortality
was .52 per cent.
Scarlet Fever.
666 cases were notified during the year, or only 2 less than in the previous
year. 663 of these cases were removed to hospital. The death rate for the
whole Borough was .1 per 1,000 of the population. 88 cases were wrongly
diagnosed; there were 22 deaths of which 13 were in children from 1 to 5
years of age, and 9 in children between the ages of 5 and 14; the case mortality
was 3.8 per cent. Last year the case mortality was 2.2 per cent.
During the year a new agreement was drawn up with the London County
Council with regard to the arrangement whereby bacteriological specimens
are examined at the Mile End Laboratory. This new agreement arranged for
the transmission by post to the general practitioners of new swabbing outfits
in exchange for those swabs sent for examination. In this way it is certain
that every general practitioner is kept supplied with outfits. At the same
time the requisition form, which each doctor completes on sending a swab for
examination, was simplified and was amended to include the examination of
swabs for the purpose of discovering carriers of virulent bacilli.
In order that too much encouragement should not be given to the diagnosis
of diphtheria on swab results, the following is printed on the reverse side of
the amended requisition form:—
" One or more negative swabs do not necessarily exclude the possibility
of diphtheria, and therefore
" (1) Anti-toxin should be given at once to all cases which are clinically
suspicious without waiting for the bacteriological report;
" (2) Cases which are clinically definite should not be kept at home until
the result of the bacteriological examination is reported but should
be certified and removed to hospital in the usual way."
Diphtheria.