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VI.— PREVALENCE OF, AND CONTROL OVER,
INFECTIOUS AND OTHER DISEASES.
Notifications.— 1,596 notifications (other than of tuberculosis) were
received, or 1,163 less than in the previous year, largely due to the absence
of measles during this year. The notification rate for the whole Borough
was 7.8 per 1,000 of the population.
Scarlet Fever.— 381 cases were notified during the year, or 115 less than
in the previous year. 370 of these cases were removed to hospital. There
were no deaths from scarlet fever during the year.
Diphtheria.— 644 cases were notified during the year, or 167 more than
in the previous year. 638 of these cases were removed to hospital. The
death rate for the whole Borough was .03 per 1,000 of the population. There
were 7 deaths, of which 6 were of children from 1 to 5 years of age, and 1
child over 5 years of age ; the case mortality was 1.08 per cent., the same
as in the previous year.
Anti-Diphtheritic.- This serum is supplied on request to the
general practitioners of the Borough. During the year 40 tubes, each containing
4,000 units, were issued from the Public Health Office.
Diphtheria Immunisation.— The following is a report of the work at the
Council's Diphtheria Immunisation Clinic from Dr. W. W. King Brown, the
Council's part-time Medical Officer of the Clinic.
"This is the first occasion on which it has been possible to review briefly
a whole years' work of the clinic. From the table appended it will be seen
that the clinic has made considerable progress, and on the whole the attendance
can be considered satisfactory.
"It is interesting to note that 21 % of the children tested gave a 'Schick
negative' response to their test. This indicates a fairly high degree of 'herd
immunity' to diphtheria. This is the usual experience in crowded areas.
"During the greater part of the year, the method of immunisation employed
was that of three injections of toxoid-anti-toxin mixture (T.A.M.) as outlined
in last year's report, and the results of final Schick tests in the table refer to
this method. The figure of only 2.7% still susceptible after the test can be
considered good, but it is hoped that it will be improved upon.
"In October it was decided to try a two injection method of immunisation
using alum precipitated toxoid (A.P.T.). It was thought that the reduction
in the number of doses required from three to two would perhaps result in
a greater number of children completing the full course of treatment.
"During the year under review none of these latter cases came up for the
final Schick test, so that nothing can yet be stated as to the efficiency of the
Schick test in Stepney, but from experience elsewhere it will be probably
found to give a result at least as good as the T.A.M. method, and possibly
somewhat better.
"During 1937, five children who had attended the clinic were notified as
cases of diphtheria. Of these two had not completed their treatment, and
so these cannot be considered as cases of failure to immunise, one was found
to be a carrier and not to be suffering from clinical diphtheria, and in the