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37
A.W., sickened on the 11th October, and a doctor was called
in. A brother was similarly ill three weeks previously but no doctor
in attendance. A sister developed the disease on the 22nd
November. These children were home nursed.
M.L., fell ill on 23rd October, a sister was attended five weeks
previously for tonsilitis. When Marjorie was visited, the sister
supposed to have tonsilitis was peeling on hands and feet—
the sequelae of Scarlet Fever.
E.M., was notified on the 22nd October. Three weeks previously
the child had been ill but no doctor called, the boy returned to
school and subsequently, owing to peeling on hands, was taken to a
doctor who notified the case.
E.B., was notified on the 3rd September. A brother was found
peeling on hands and had a history of illness a month previously ;
another brother suffered from a rash in the second week in August.
The mother considered both children suffered from nettle rash and
did not seek medical advice; George had also a similar rash.
These three were either at work or school until E.B. was taken
seriously ill and removed to Hospital. On visiting the home,
subsequent to notification of E.B., the unrecognised cases were
brought to light and the necessary precautions taken.
DIPHTHERIA AND MEMBRANOUS CROUP.
During the year 375 cases of this disease were notified—38 by the
Medical Officer of Health.
The numbers are less by 50 than in 1919, and greater by that number
than the average of the ten proceeding years.
Of the total, 325 were persons aged 15 years or under, 34 between 15
and 25 years, 12 between 25 and 45 years and the remaining four over
those ages.
The months of greatest incidence were January (67) and March (43),
and the minimum August (17) and December (20), the average monthly
rate being 31.
In January the largest number of cases were brought to light by
myself.
The attack-rate for the whole population was 2.82 per 1,000 as
compared with 2 29 for the previous ten years, and the death-rate was
.14, which was also less than the average and less than that of London
or the country as a whole.
Experience shows that the disease in its incidence and spread is due
to causes very similar to those governing Scarlet Fever.
During the school holidays the children lose the valuable control
exercised over them by the school teachers, and unless seriously ill are
not seen by a doctor.