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Pneumonia.
Including 129 from the West Middlesex County Hospital, 159 notifications of pneumonia
were received. Ninety-nine of these cases were non-residents.
Dysentery.
Two cases were notified, one of whom was a non-resident. No source of infection was
traced.
Influenza.
No epidemic of influenza occurred during 1938. Six deaths were certified as due to
influenza. This yields an influenza death rate of 0.06 per 1,000 population as compared with
0.38 in 1937.

According to information obtained by health visitors the extent to which these cases were
under medical care was as follows:—measles—83.12%; german measles—45.62%; chicken-pox
—49.0% ; mumps—51.20% and whooping cough—68.0%. During 1938 one death was certified
as due to whooping cough and two deaths as due to measles.
Measles Prophylaxis.
During the early months of 1938, measles serum was issued as follows:—150 c.c. to
medical practitioners; 100 c.c. to West Middlesex County Hospital and 80 c.c. to the South
Middlesex Fever Hospital. Apart from Dr. Rankin's report which follows, no records are available
in the department to show the effect of the serum in regard to prophylaxis or attenuation.
SERO-PROPHYLAXIS OF MEASLES, 1938.
Details of Exposure.
Group 1. A case of measles, wrongly notified as scarlet fever, admitted to a scarlet fever
ward on 14th March resulted in the exposure of six children (ages 14, 2, 3, 4, 4 and 13
years) who had not suffered from measles previously. On the second day of exposure
each child was injected with 10 c.c. of measles serum intramuscularly. Measles did not
develop in any of these six children within a period of twenty-six days from the last
exposure.
Group 2. Two children, 6 and 7 years of age respectively, were exposed to infection with
the measles virus in a scarlet fever ward on 14th April. One of these children occupied a
bed adjacent to the infecting case, whilst the other child was more distant. The day
following exposure each child received 10 c.c. measles serum intramuscularly. Neither
child developed measles during the period of observation of twenty-six days from the last
exposure.
Group 3. A child admitted to Hospital on 12th May suffering from scarlet fever developed
measles on the fourth day after admission. Five children from one to seven years of age
(1, 2, 4, 5 and 7 years) who had not suffered from measles previously, were exposed to
infection from the above case. On the third day of exposure, four of these children were
injected with 10 c.c. of measles serum intramuscularly. There was no evidence of measles
in three of these cases up to the date of discharge, which was a minimum of twenty-six
days from the last exposure. One child, a girl (aged 7 years) developed measles which was
nrld and uncomplicated. On going into the history of this case it was found the patient
had been in contact with a case of measles at school four or five days before admission
to hospital. She accordingly had received the measles serum on the 8th day following the
first exposure.
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