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began treatment—were invited to be post Schick-tested some
months after the completion of the course. Of the 675 tested,
18 were still positive, though the majority of these gave a very slight
reaction. This does not represent a conversion of 97.3 per cent.
from a state of susceptibility to one of immunity, as the large
majority were not Schick-tested before being treated. As most of
the children, however, were under the age of ten there were probably
only a few who were originally Schick negative. Those reacting
positively were referred to their medical practitioners for further
inoculation.
Provision of Anti-Toxin.
Diphtheria anti-toxin is available free of charge to medical
practitioners for the treatment of necessitous patients. 24 lots
were issued, totalling 160,000 units.
SCARLET FEVER.
Incidence.
501 cases of scarlet fever were notified during the year, a fall
on the figure for the previous year, and being an incidence rate of
3.47 per thousand compared with a figure of 2.96 for the country
as a whole.
In the previous year the average of weekly notifications,
which had been eight or nine for the most of the year, from
September onwards reached a figure of 20. This figure gradually
fell from an average of 18 in January to 13 in May. For the rest
of the year the weekly notifications were only single figures, the
lowest incidence in September being a rate of four per week,
following which there was a gradual rise until in December the
average weekly notifications were seven.
In the earlier months of the year the accommodation at the
isolation hospitals proved insufficient, patients having to be sent
to hospitals of other authorities, a total of 61 being treated outside
during the year. 115 patients were treated at home at the election
of the parents. For the first six months of the year scarlet fever
patients were admitted both to the Rayners Lane and the Honeypot
Lane Hospitals. From the 1st July, however, the Stanmore
Hospital has been used only for the reception of convalescents,
all patients in the acute stage being treated at the Rayners Lane
Hospital. In the ordinary uncomplicated cases the transfer is
made early in the third week of the patient's illness.
There were 15 cases missed at the onset, but diagnosed in the
later stages. In the case of some the diagnosis was made when the
medical attendant was called in for the first time to see the second
patient; in other cases the parents would first have sought advice
on noticing the peeling.