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As sanitary authorities have to deal with the disease when it arises, it
would be well had they the control of the measures to be taken for its
prevention.
With this disease, the Council is very much in the position of locking
the stable door when the steed is stolen.
SCARLATINA OR SCARLET FEVER.
Two hundred and ninety-two cases of scarlatina were reported during
the year; the mean number of cases for the previous ten years being 357.
Considering the great increase of the population, the year under
review was a very favourable one. On page 25 will be seen the number
of cases notified each year since 1889.
It will be seen that the incidence of this disease varied greatly,
averaging about 5 per 1,000 of the population, compared with 3 per
1,000 for 1903.
At no period of this year could the disease have been said to be
epidemic. The greatest number, 40, occurred in January and April,
and the least number, 15, in November.
Six deaths occurred from this disease during the year.
Four of the deaths occurred at the Sanatorium and one at West Ham
Union.
The case mortality—the proportion of deaths to number attacked—
was slightly over 2 per 100, and the mean annual death rate per 1,000
was .056, or half what it was for the country generally. Three of the
deaths were in children under 5 years, and all the deaths under 15.
The greatest number of cases, 73, occurred in the High Street Ward,
and the least, 27, in the Wood Street Ward.
The large number of "flats" in the High Street Ward may account
for the prevalence and easy spread by inter-communication. A typical
case of scarlatina is most easily diagnosed, but in recent years the complaint
has become so mild an affection that at times the greatest
difficulty is experienced, and I have no doubt many very mild cases are
never recognised, with consequent spreading of the disease.
The opposite error of mistaking rubeola for scarlatina is quite common,
but fortunately the error is on the right side, and no harm is done
in consequence.
Two of the 172 cases sent to hospital as scarlatina were measles—a
very small per centage of error.