View report page

61
attains the age of two, and again at three, and then again just before
he is admitted to school. For those who are susceptible, and they will
include most adults who need to be treated, T.A.F. is recommended as an
antigen less likely to cause reactions. This is supplied free of cost to
the doctor wishing to use it.
Immunisation of the infant is now advocated at six to nine months,
so that the full effect of the inoculation, which takes some three months to
develop, will come into play by the time the infant is losing his natural
immunity and is reaching the stage when he is more likely to come into
contact with infection.
Provision of Anti-toxin.
Diphtheria anti-toxin was first made available for issue under the
1910 Anti-toxin Order, under which it could be issued to medical practitioners
for the treatment of the poorer inhabitants of the district.
These powers were extended by the provisions of the Middlesex County
Council Act, by which a local authority could provide with or without
charge to any registered medical practitioner antidotes and remedies
against notifiable diseases. Advantage was taken of these powers to
supply diphtheria anti-toxin for medical practitioners to administer to
any of their patients suspected of suffering from diphtheria. Supplies for
issue were kept at the Isolation Hospital, at the Public Health Office and
also at the Fire Stations. Under the National Health Service Act, the
Regional Hospital Boards are providing anti-toxin for general medical
practitioners, supplies being obtainable at the Edgware Isolation Hospital
or at the Public Health Office.
SCARLET FEVER.
Incidence.
Scarlet fever is a disease which is always present to some extent in
a district of any size and which has a seasonal prevalence, being more
common in the autumn, about 20 per cent. of the population suffering
at some time or other from the illness. In the years between the two
wars, the national incidence ranged from about 2.0 to 3.5 per 1,000
population. Local rates have ranged from 1.06 to 4.70 per 1,000, the
number of cases each year from 1934 being 621, 501, 423, 415, 500, 316,
207, 326, 618, 672, 346, 270, 248 and 180, these being rates per 1,000
population of 4.70, 3.47, 2.64, 2.31, 2.72, 1.60, 1.60, 1.06, 1.66, 3.52, 1.87,
1.41, 1.38 and 0.83. 1948 was a year of low incidence. Four of the 185
patients notified as suffering from scarlet fever were subsequently found
to be suffering from some other condition. The net figure of 181 was an
incidence rate per 1,000 population of 0.82. The rate for the country as a
whole was 1.73. There was this year no autumnal increase in prevalence.
For the first two quarters of the year the average weekly number of notifications
was four ; in each of the last two quarters the figure was three.
Deaths.
There were no deaths in the district from scarlet fever. This infection
for part of the last century was a dread disease with a case
mortality of up to 16 per cent. To-day in this country the case mortality