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20
The actual cases undergoing treatment only represent a small
fraction of the waste resulting from the presence of the disease. It
would, be fair to state, for instance, that for every case removed to
hospital, 10 medical examinations have been made of suspects such
as chickenpox cases, contacts, suspicious cases referred by the family
doctor, cases referred by the School Authorities, and so on. In the
investigation of these cases there occurs suppression of facts, false
information, the actual following up of hundreds of contacts, arranging
disinfection, and so on, so that the actual cases can give little impression
of the waste of time, money, and effort involved. The actual
number of contacts under supervision during 1929 was 3,494, although
the number of cases in this Borough was only 72 during that year.
It should be borne in mind that it is impossible to distinguish between
degrees of contact. A contact is a person who has been in the company
of a person actually in an infectious state whether for a short
or long period; all such persons must receive the same supervision.
From January 1st to May 31st, 1930, there have been 345 cases of
smallpox in Hackney.
The Council have arranged for an additional Sanitary Inspector
and three nurses for visiting, extra clerical assistance has also been
provided, and I must mention the enormous assistance given by Dr.
Barlow, the Deputy Medical Officer of Health, whose skill and energy
have made it possible to carry on without disaster or serious complaint.
Some notes with regard to the diagnosis of smallpox were circulated
to the general practitioners of the Borough (page 27).
A comparative table for the Borough, showing the death, birth,
and infantile mortality rates for the past 10 years, is set out on
page 39.
The death-rate for Hackney for the past year is 13.9, an increase
on the previous year's rate of 11.7, this rate being slightly higher than
the County rate, which is 13.8, as compared with 11.6 for the
previous year. Influenza showed the most striking increase as regards
the deaths.
The infantile mortality rate of the Borough, measured by the
number of deaths under one year of age per 1,000 births, was 56.7,
as compared with 67.0 for the previous year; the Borough average
during the last five years, 1925-1929, is 62, as compared with 67 for
the previous five years. The figure for London for the year 1929 is 70.
The zymotic death-rate is 0.47, as compared with 0.54 for 1928.
The number of scarlet fever cases notified during 1929 was 856, as
compared with 947 in 1928, and the number of diphtheria cases notified
in 1929 was 670, as compared with 741 during 1928. The deaths
from scarlet fever numbered 1, being six less than the previous year,
and the deaths from diphtheria 28, this figure being the same as that
for 1928. A Diphtheria Immunisation Clinic commenced work at 28.