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of an infection with the streptococcus family of germs which can
cause many conditions including sore throat without rash and sore
throat with rash which may be called Scarlet Fever. Both conditions
are infectious and it will be clear that a patient with a
sore throat and little or no rash can infect others if not isolated.
It would seem, therefore, that notification and treatment in Hospital
wards of only those patients with a rash is irrational and that
isolation of all cases of streptococcal sore throat should be undertaken,
removal to hospital depending on the severity of the disease,
the home nursing facilities, the employment of another member
of the household in the preparation or distribution of food for
public consumption or the approaching confinement, say within
one month, of any female in the patient's home.
Finally, in view of the most recent knowledge regarding the
streptococcus, it seems advisable to visualise the future Hospitalisation
of Scarlet Fever cases in cubicles or small wards.
Diphtheria.
During the year thirteen cases of Diphtheria occurred, all
except one being removed to Hospital for treatment. Seven of
these patients were school children, four were female adults and
two were pre school children. Two of the cases were fatal—a girl
of 3 years and a female adult, neither of whom had been immunised
and both of whom were seen by their Doctor only a matter of
hours before death. All of the remaining eleven cases were of
a fairly mild or moderate degree of severity and only three of
them had been immunised.
The number of cases during the year is an increase from the
very small numbers recorded during the previous three years and
serves to stress the fact that Diphtheria will continue to be a danger
until a higher proportion of the population has been successfully
immunised, especially in view of the possible increase in the carrier
rate.
Diphtheria Immunisation.
Number of children immunised during the year :—
Under 5 years 494
Between 5 and 15 years. 466
Total 960
The number of children immunised during the year was lower
than during the previous two years which marked the commencment
of the intensive campaign for Diphtheria immunisation.
When it is realised that it is estimated that in Chingford 71% of
the children under 5 years and 76% of the children aged between
5 years and 15 years have been immunised as at 31st December,
1943, it will be understood that the position is fairly satisfactory
and that efforts must now be directed primarily to endeavouring
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