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sewermen and emphasising the desirability of advantage being
taken of the arrangements made by the Council for the diagnostic
examination of blood and urine for which the Council were prepared
to pay.
The Department has been informed of four further cases since
that year, two in 1938 and two in 1950. All the patients, who
recovered, had been employed by the Borough Council as sewermen.
The year 1921 saw the incidence of Scarlet Fever and Diphtheria
rise to what subsequently proved to be the highest for the next 30
years. In that year 1,863 cases of scarlet fever were notified,
from which 6 deaths resulted, whilst the diphtheria cases numbered
872, with 46 deaths.
During 1922 considerable anxiety as to the possibility of
an outbreak of Smallpox in Hackney was experienced. Fortunately,
no cases were notified but it was necessary to keep under observation
36 contacts of cases notified in other boroughs, and, as usually
occurs during periods of anxiety due to smallpox, a considerable
number of illnesses were suspected of being smallpox, the majority
of them being severe cases of chicken pox.
The first notification of smallpox to be received while I was
Medical Officer of the Borough came in 1923, when a case occurred
among a family living in one of the Council's converted army huts.
The infection as far as could be ascertained was incurred at a
laundry where the patient had been engaged in washing bed clothing
from a hotel in Central London where a case of smallpox, unrecognised
at the time, was known to have paid a visit and to have
infected a servant employed at that hotel. The laundry was
visited, notices regarding smallpox posted, a list of the employees
and their condition as regards vaccination compiled and the
manager requested to give information as to any employee absent
through illness. All necessary disinfection was carried out and the
Ministry of Health and postal authorities were notified of the case
and the medical officers of health of the boroughs concerned were
notified of the contacts. All the contacts escaped infection.
In the following year, 1924, there was a great increase in the
number of cases of Encephalitis Lethargica, 34 such cases being
notified, from which there were 11 deaths. This obscure disease
which occurred in epidemic form in the Spring of 1918, and was
believed to be associated with the world-wide influenza epidemic
of that year, was prevalent in many parts of the world between the
years 1920 and 1926 but is now fortunately less so. The disease,
which invariably proves fatal, although death sometimes occurs
some years after the original infection, was made notifiable under
the Public Health (Acute Encephalitis Lethargica and Acute
Polio-Encephalitis) Regulations, 1918.