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What I said in last year's report is true as applied to 1902:
"The inadequate accommodation for Scarlet Fever cases at the
Sanatorium hampered the work of the prevention of the spread of this
disease very much, and many of the cases could have been prevented if
first cases were isolated. Especially was this the case where houses
were occupied by two families, and, strange to say, practically every
person in charge of a Scarlet Fever case was anxious to have it removed
to the Sanatorium, whereas there were many who refused or did not
care to allow the cases of Diphtheria to be removed.
The long isolation, and consequent inconvenience in small households,
was accountable for this, though, from a public health point of
view, Diphtheria is much more necessary to be properly isolated, its
death-rate being very high, while that of Scarlatina is very small.
Eight hundred and thirteen houses were disinfected by your
authority, or by the householders to the satisfaction of their medical
attendants. In all cases we have tried to have the work done under
skilled supervision, feeling that under your authority it is done much
more efficiently and thoroughly than in private hands. In all cases
bedding and other infected articles capable of removal were taken to
the disinfecting station and disinfected by means of a Washington Lyon
Disinfector."
SMALL POX.
In my Annual Report for 1901 I gave the origin of the outbreak of
this disease in your district, and carried its history down to the 27th
February, 1902.
Owing to the extreme pressure put on the Authorities providing for
small pox accommodation, many unvaccinated workmen were allowed
to work at the erection of temporary small pox hospitals, with the
result of taking the disease and bringing it to their homes, many of
them being located in your district. Owing to this fact many cases
occurred in your district which were preventable.
The action taken by your Authority with reference to the patients
in Hospital need only be referred to, and you have already expressed
to the West Ham Authority your thanks for taking in every case sent
to Dagenham.
During the year 146 cases of small pox were notified and removed
to Hospital. Of these 20 died from the disease, showing a case rate
of 137 per cent., or in other words 3 in every 22 persons attacked
died from the disease.
The death rate per 1,000 of the population from small pox was -194.
Contrary to expectation so far, March, 1903, no recrudescence of the