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CEREBRO-SPINAL FEVER. During the year 8 cases
were notified, of which 5 were males and 3 females. The case
rate was 0.049 per 1,000 of the population. There were 2 deaths
giving a death rate of 0.012 per 1,000 of the population. All
cases were removed to hospital.
ERYSIPELAS. The number of cases of erysipelas notified
during the year was 47, of which 19 were males and 28 females.
The case rate was 0.29 per 1,000 of the population. There were
no deaths from this disease. The number of patients removed
to hospital was 15.
DYSENTERY. There were 29 cases of this disease
during the year, 26 males and 3 females. The case rate was
0.18 per 1,000 of the population. The number of patients
removed to hospital was 22.
MALARIA. There were 14 cases of this disease notified
during the year—all were males. All cases were believed to
have been contracted abroad.
DIARRHOEA AND ENTERITIS. During 1946 the
number of deaths of children under 2 years of age from
diarrhoea and enteritis was 24. The corresponding figure for
1945 was 21. Of the 24 children who died, 15 were males and
9 females. The death rate per 1,000 of the population was 0.15.
A distressing outbreak of this disease occurred during the
year in the maternity wards at Forest Gate Hospital. Starting
on 19th January, it rapidly affected five babies in one ward.
These cases were immediately isolated and the ward placed in
quarantine. In the course of investigation it was found that
one of the Orderlies employed on that ward was suffering from
diarrhoea, and it soon became evident that other members of the
nursing and domestic staffs employed on other wards had
become infected, and despite the rigid precautions taken at the
onset, the disease spread to all the other maternity wards. The
admission, a little later, of some patients who were found to be
suffering from diarrhoea doubtless added fresh infection.
In addition to the temporary quarantine of the ward first
affected, various measures of control were adopted. The
number of beds was reduced from 80 to 66, partly to relieve
overcrowding and partly to relieve the depleted staff from some
of their burden of overwork, while arrangements were made to
transfer a proportion of the lying-in mothers in the later stages
of the puerperium to other accommodation in order to maintain
the flow of admissions unimpaired. The beds which were
retained were more widely spaced so that each mother had at
least the recognised minimum of 90 square feet of space and
each baby at least 30 square feet. A careful overhaul of aseptic
and nursing technique was undertaken on more than one
occasion and the whole subject kept constantly under review:
and many structural modifications were undertaken or initiated
on the recommendation of the Ministry to assist this end. Yet
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