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The district was again fortunate in experiencing a comparatively light incidence of
infectious disease, and the number of cases of scarlet fever and diphtheria notified did not differ
to any appreciable extent from those notified during the previous year.
Scarlet Fever.
Most of the cases admitted to the hospital were of a mild or moderate type. Scarlet
fever anti-toxin was administered to 30 out of the 35 cases classed as moderate, and its effect in
producing a rapid fall to normal of the temperature, fading of the rash, increased comfort on
the part of the patient, and marked diminution of the desquamation stage, was too evident to
be merely accidental.
The influence of the scarlet fever anti-toxin in reducing the tendency to complications
is not easy to estimate accurately. Of the total cases of scarlet fever admitted during the year,
the percentage of patients in whom middle ear suppuration developed was 4.7 ; of those to whom
scarlet fever anti-toxin was not administered the figure was 4 per cent., and of those to whom
scarlet fever anti-toxin was administered, 6.6 per cent, developed ear complications. It must
be pointed out, however, that scarlet fever anti-toxin was only given to the moderately severe
cases, which would be those among whom ear complications would be more likely to occur,
while, in addition, the undesirability of attempting to draw conclusions from percentages based on
small numbers must also be borne in mind.
The adminstration of scarlet fever anti-toxin did not appear to have any influence in
reducing the occurrence of cervical adenitis. Its use, however, has certainly enabled us todischarge
patients at an earlier stage than was formerly the practice. Excluding cases in which
the diagnosis of scarlet fever was not confirmed on admission, three-fifths of the cases were
discharged from hospital between 21 and 30 days after admission.
Diphtheria.
Of the cases of diphtheria admitted to the hospital, three were of severe type, twomoderately
severe and the remainder mild in character.
Other Diseases.
One severe case of erysipelas, one of chicken-pox and one of complicated measles were
admitted, but the limited accommodation at the hospital does not permit the admission of more
than occasional cases. Fortunately, however, measles was almost entirely absent from the district
during the year and, in consequence, requests for admission of cases of this disease were not
numerous.
Information as to the occurrence of cases of infectious diseases which are not compulsorily
notifiable is obtained satisfactorily from the schools and the Health Visitors and is acted upon as
far as possible.
No arrangements were made to provide immunization against diphtheria or scarlet fever
either in schools or elsewhere.
No special steps have been taken to investigate or deal with cases of cancer. Cases of
inflammation of the eyes in infants (ophthalmia neonatorum) are visited by the Health Visitors,
nursed, if necessary, by the Nursing Association Nurses and re-visited until the termination
of the case. No definite case was met with during the year.