View report page

it will be seen that infections still play a prominent part
in infant deaths. In theory all such deaths are preventable
and in actual practice most can be prevented. The great difficulty
is to find out when and how the breakdown in practice has
occurred and this is specially so in cases of gastro-enteritis.
This disease continues to give rise to anxiety by reason of its
increased incidence and high mortality.
The maternal mortality rate of 0.62 is the lowest recorded
since 1930 when the present method of calculation was introduced.
The still-birth rate per 1000 total births was 26 as compared with
32 in 1942 and 35 in 1941.
Scarlet fever was more prevalent that in 1942, but continued
to be of a mild type and caused no death. Since 1940 the
admission of cases of scarlet fever to hospital has been restricted
and has been determined by (1) the severity of the disease,
(2) the home-nursing and isolation facilities and (3) the employment
of another member of the household in the preparing or
distribution of food for public consumption. Scarlet fever is
due to a throat infection by haemolytic streptococci, but these same
streptococci may give rise to a similar sore throat with no rash.
There is no justification for isolating in hospital only
streptococcal sore throats associated with a rash and Ignoring
those with no rash as this will not protect the community.
Further, the complications of scarlet fever are almost wholly
due to cross-infection, which seldom occurs if the- patient is
nursed at home. Objection is sometimes raised to the inconvenience
arising from nursing cases of scarlet fever at home, but
the welfare of the patient must be the first consideration.

Where more than one case occurred in a household consideration
of the dates of onset of the second or subsequent cases
showed that in th majority infection had occurred previous to
the diagnosis of the first case. In other words, if the casecan
be isolated at home there is no advantage to the community
in removing it to hospital. All persons suffering from
tonsillitis should be considered Infectious and should remain
in isolation at home until the attack hrs subsided.
In regard to diphtheria only 5 cases occurred and this is
the lowest incidence in the 48 years for which records are
available. Also for the first time, no deaths from diphtheria
are recorded. At the end of the year 37.97 per cent, of the
population under 5 years of age and 77.1^ per cent, of the
population between 5 and 15 years were immunised. There is no
doubt that this low incidence and mortality are due largely to
the campaign of immunisation against diphtheria, which has been
in operation here since 1930. It is to be hoped that parents will
not grow negligent in protecting their children against
diphtheria as the disease can be controlled only by maintaining
a high proportion of immunised perrons in the population.
2.