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89
ment from various sources in that year, and the investigation of
the home conditions of all these cases in addition to smallpox
cases and contacts and other infectious disease enquiries, placed
so great a burden upon the department that it was found necessary
to engage a special visiting nurse.
The following year saw the number of notified cases of smallpox
drop to 34, which was followed by 13 in 1933 and one, the last
case, in 1934, and it is pleasing to record that no further death
occurred.
In 1931 there was a considerable increase in the number of
cases of Pneumonia, which had been notifiable since the influenza
outbreak in 1918. Previously the number of notified cases had
averaged 66 a year, the highest numbers being in 1920 when there
were 97 cases and 1929 when there were 109 cases, but in this year
the number of cases jumped to 187 and the next nine years was to see
an annual average of 166 cases, after which the numbers began to
drop off.
Among the four cases of Para-Typhoid Fever notified in 1937
was a girl of 15, one of a number of refugee children to arrive in this
country from Bilbao, Spain. The children were first put in a camp
at Eastleigh, Hants., and later 400 of them were transferred to the
Salvation Army, Congress Hall, Clapton. On the day they arrived
in Hackney the accommodation provided for them was inspected
and the girl who later developed para-typhoid fever was reported
to be indisposed with "a slight stomach disorder". Her condition
was later diagnosed as typhoid or para-typhoid and the samples of
blood sent for examination confirmed the diagnosis as para-typhoid.
The girl was removed to hospital and disinfection carried out that
day. Thereafter a daily inspection of the premises was made and
all other cases of illness occurring from time to time among the
children were investigated, bacteriological examination being
carried out where necessary.
At the time of the children's arrival no arrangements for their
regular medical inspection or for adequate isolation and care
of any child suspected of any infectious disease had been made
but, later, isolation accommodation was arranged, medical and
nursing staff were provided by the Army authorities and other
necessary measures to prevent the spread of infection were carried
out. It is pleasing to report that no further case of infectious disease
occurred among the children although they arrived in Hackney
on the 26th May, and the last of them did not leave the Borough
until the end of August.
The year 1938 saw the County of London (Measles and
Whooping Cough) Regulations, 1938, issued, under which Measles