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subsequently found to be wrongly diagnosed. The corrected diagnoses (as
supplied by the hospitals) were:—Tonsillitis, 20; "Not Diphtheria," 5;
Vincent's Angina, 3; Erythema, 1; Bronchial Catarrh, 1; Catarrh, 1;
Stomatitis, 1; Lobar Pneumonia, 1; Scarlet Fever, 1; Cardiac
Irregularity, 1; Gingivitis and Pyorrhoea, 1.
Of the 252 notified cases, 227 were removed to hospital.
Bacteriological examination of swabs for the presence of the
Diphtheria organism is undertaken at the Health Department's
Laboratory. 1,994 swabs were examined, and 255 proved to be positive.
Where successive swabs prove the continuance of the presence of
Diphtheria Bacilli, virulence tests are made for the department by the
Prince of Wales's Hospital Pathologist.
Scarlet Fever.—Reviewing the incidence of Scarlet Fever for each
of the past 6 years, it will be noted that the year 1921 showed a very
marked accentuation. The incidence of the disease reached its low level
in 1924, and in this instance—as in the case of Diphtheria—the numbers
notified were practically as 3 to 1; and again, it is to be noted that the
deaths and Death-Rate have shown a steady declension, so that for the
past 2 years there has been no mortality at all.
During the period under review a reversal of policy has taken
place in Tottenham with regard to Scarlet Fever administration. The
1921 epidemic proved that in time of real stress the hospital accommodation
available for Tottenham patients was totally inadequate,
and in April, 1922, resort was had to other means than hospitalisation
of handling the epidemic. Nurses were appointed to treat patients in
their own homes, and thus pressure on hospital beds was relieved. The
experience gained by the experiment thus forced upon us indicated that
for a large proportion of Scarlet Fever patients institutional treatment
was unnecessary, so far as the illness was concerned. In some respects,
treatment at home had advantages over hospital treatment, notably
in the avoidance of cross infections. The menace attaching to the
retention of Scarlet Fever patients in their own homes is the occurrencec
of secondary cases—one that must be admitted. On page 48 are set
forth the details of the cases treated at home during 1925.
In order to obviate the occurrence of secondary cases, recourse was
had, in 1924, to the use of Scarlet Fever anti-toxin for the inoculation
of susceptible contacts. A passive immunity appears to be conferred
for a period of about a fortnight by the intramuscular injection of 5 c.cm.
concentrated serum. The susceptibility to the disease is thus postponed