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18 Notifiable Infectious Diseases.
DIPHTHERIA.
The usually severe epidemic of Diphtheria which commenced
in this district in the autumn of 1921, and which was associated
with and followed on the appearance, in epidemic form, of
Diphtheria in the County of London, was declining at the end of
that year. Through January and February of 1922 the epidemic
continued to decline, and in March there was very little Diphtheria
in the District. An outbreak of limited proportions occurred
during April and May, but from then onwards until the end of the
year the number of cases occurring were comparatively few.
The number of cases notified during the year was 65, of which
61, or 94 per cent. of the cases, were removed to Hospital; only 4
cases were treated at home. Every case where it was considered
isolation and treatment could not be effectively carried out at
home was removed to Hospital.
The incidence rate (cases per 1,000 of population) was 1.90,
compared with 1.37 for England and Wales, and 3 38 for London.
Had the incidence rate in Barnes corresponded to that in London,
there would have occurred in the District 115 cases, and an
incidence-rate in the District corresponding to that of England and
Wales would have given only 48 cases.
Three deaths occurred, representing a mortality rate per 100
cases of 4.61, compared with a rate of 8.00 per cent. for England
and Wales, and 7.44 per cent. for London.
Of three fatal cases one died 3 days after admission from
acute toxæmia; in the other two cases death was due to heart
failure associated with diphtheritic paralysis. In a large proportion
of the case? admitted to Hospital the disease was of a severe type.
The majority of the severer cases were sent into Hospital at the
beginning of the illness, and a fatal issue was avoided by the early
administration of Antitoxin ; a small number of cases unfortunately
still come into Hospital rather late in the course of the disease, and
even where a fatal termination is avoided in these cases the illness
is liable to be far more serious and more protracted than it otherwise
would be. To enable an early diagnosis to be arrived at
and to secure prompt administration of antitoxic serum,