View report page

Measles.
A severe epidemic of this disease was present in the district
at the beginning of the year. Of 14 cases which proved to be
suffering from measles on admission, 6 had been notified as
diphtheria, 7 as scarlet fever, and 1 as whooping cough. Three
diphtheria patients and 8 scarlet fever patients were admitted
incubating measles and developed the disease in the wards within
a week of admission. From these cases, 8 diphtheria patients and
6 scarlet fever patients were infected in the wards.
Thirteen of the cases were notified as measles and laryngeal
diphtheria. Tracheotomy was performed in 7 of these cases, and
3 of them proved fatal. Eleven other cases were complicated bynasal
diphtheria.
Six cases were in residence at the beginning of 1930, and 86
were admitted during the year, making a total of 92 cases under
treatment. Of these, 77 were discharged recovered, and 15 died,
giving a fatality rate of 19.48 per cent.
The Encephalomyelitis of measles:—One case, a girl, A.S.,
aged 6 years, was admitted on the 31st January suffering from
this rare complication of measles. Her illness had commenced two
days previously with sleepiness. On admission a general intense
morbiliform rash was present. The temperature was 98 degrees
Fahr., pulse 108 and respirations 28. The tongue was dry and
furred, the buccal mucous membrane was deeply congested, and
Koplik's spots were present. There was no cough or catarrh,
and the temperature did not rise above normal throughout the
course of the illness.
The patient was deeply comatose on admission; there was
slight rigidity of the limbs, but there was no head retraction. A
lumbar puncture gave 18 c.c. of slightly turbid fluid under pressure.
It contained a large number of lymphocytes and polymorphs
but no micro-organisms were discovered. The lumbar punctures
were repeated during the following days, and clear fluid under
pressure was obtained for the first three days, but otherwise the
examinations were negative. The patient continued extremely
restless for the first eight days, constantly moaning and throwing
her arms and legs aimlessly about. She then became very
quiet, and lay in this comatose condition for about another three
weeks. She was fed by nasal catheter for the first ten days, but
was afterwards able to swallow food mechanically. After about
six weeks the first signs of returning intelligence began to appear.
She then continued to make steady progress, but she had complete
aphasia for another six weeks. She, however, made a complete
recovery, and when seen nine months later was perfectlv normal.
Whooping Cough.
This disease was not prevalent during the year. Thirteen
eases were under treatment. Of these, 12 were discharged recovered,
and one died. The fatal case was a child aged 17
months. In addition to these the disease w as present as a complication
in one case of diphtheria and in one case of measles.
101