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3°
Typhoid or Enteric Fever.
Apart from cases occurring in the St. Marylebone Schools there
were four cases of this disease notified during the year, as compared
with six for 1903. There is no importance attaching to these cases
from a Public Health point of view, as they were all due to causes
outside our jurisdiction. The first case was one of Typhoid
Pneumonia; in the second case the patient came home with
symptoms of the illness from a holiday in Lincolnshire. The third
case occurred in a caravan at North Hyde; and the fourth, I am
given to understand, was the result of influenza.
The cases were removed—with one exception—to the West
London Hospital, and our thanks are due to the Authorities of that
Institution for taking the cases in. The remarkably low incidence of
Typhoid Fever in the district which has continued for many years
past, is a highly satisfactory circumstance.
Erysipelas.
The only other notifiable disease during the year was Erysipelas
All the cases were of a sporadic nature, and do not call for any
remarks.
NON-NOTIFIABLE INFECTIOUS DISEASES.
Measles and Whooping Cough.
During the year there was a very extensive prevalence of Measles
which first appeared on the South side of the District, about the
middle of June, and the cases were limited to that area up to
September, when the disease appeared on the North side and
continued very prevalent up to the end of November. As the
disease is not a notifiable one, there are no means of ascertaining the
number of cases which occurred, but I venture to think it is the
most extensive outbreak we have experienced for many years past,
a circumstance which is explained by the large number of children in
our population of a susceptible age. Moreover, since the disease is
highly infectious before its symptoms are characteristic, it is extremely
difficult to control its spread; to this end, isolation is all important.
In a large number of cases medical advice is not sought; unfortunately,
many parents look upon Measles as a trivial and inevitable
illness, and do not even confine them to the house whilst suffering
from the disease, and thus the infection becomes widely disseminated.
It is probable that in the near future, that Measles will be definitely
included in the category of "dangerous infectious diseases," and so
give local authorities power to take proceedings under the Public
Health Act against parents who wilfully expose their children when