View report page

34
SCARLET FEVER.
Six hundred and seventy cases of this disease were notified during
the year, and 50 per cent. of the sufferers were removed to the Isolation
Hospital.
Universal prevalence of this disease in London and the neighbouring
Districts was a marked feature of the year 1920, but our experience was
that in no sense is Scarlet Fever a dangerous Infectious Disease—
infectious, no doubt, but not dangerous.
During the past ten years the type of this disease here has become
extremely mild and deaths from it are few.
In 1920 only one death occurred among the 670 contracting the
disease.
Twenty years ago it was believed that by isolation in Hospitals,
Scarlet Fever would be stamped out in time and huge sums have been
spent in the provision and maintenance of beds for this purpose. No
such claim is now made, and, as pointed out in my report for 1919, were
it not for the complications often occurring in, and the bad sequelae
associated with even mild cases, hospital treatment would almost seem a
luxury and uncalled for in the ordinary way.
The popular view of the disease, however, is quite different, and in
February, 1921, owing to the large number of cases notified, I was
called on to prepare a statement of the reasons and causes of this. The
following is a summary:—
In 1890, the first year of compulsory notification, when any approximation
to a real knowledge of the incidence of certain Diseases was
possible, it was found that our infectious sickness rate per 1,000 of the
population was 9.5.
This was followed by a rate of 13'8 and 18 5 in 1892 and 1893,
succeeded by an average of 10.9 for the three following years.
In 1900 and 1901, Diphtheria was very prevalent here and in London,
and, as invariably happens, the immediate succeeding years 1901 and
1902 were marked by excessive Scarlet Fever incidence.
The incident rate for Scarlet Fever in 1901 and 1902 was 6 per 1,000
of the population, 7 for 1905, 6 for 1907, falling to an average of 2.5
for the last 10 years.
During the first eight months of the year 1920, 257 cases of Scarlet
Fever occurred, equal to an Infectious Sickness rate of 3 per 1,000 of
the population, a figure similar to that prevailing for the previous ten
years, and lower than that for the Country as a whole.
Following the summer holidays, when the children returned to school
and came under Medical and other supervision, the notifications of
Scarlet Fever rose from 46 in August to 102 in September, followed by
101 in October, 129 in November, 81 in December, and 70 in January,
1921.