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Notifiable Infectious Diseases.
21
100 cases of 4 00, compared with a rate of 1.40 per cent. for
England and Wales and of 1.74 per cent. for London.
A larger proportion than usual of the cases admitted were
suffering from the disease in a severe form; in several of these
the disease was of the toxic type, complicated by unusually early
and severe nephritis, and to this circumstance the high percentage
mortality is to be attributed. Of the four fatal cases two died from
acute toxæmia on the second day after admission, one from acute
nephritis with suppression of urine on the sixth day after admission,
and in the fourth case death was due to uraemic convulsions on the
third day after admission.
The 100 cases notified came from 90 families. In 83 families
one case only of the disease occurred in each family. In 5 families
two cases of the disease occurred in each (in each of these families
the second case had become infected from the first case before the
latter's removal to Hospital). In one instance, where two families
occupied separate floors in one house, investigations following the
notification of a case of scarlet-fever led to the discovery of six
other cases—each of these children had suffered from the disease
in a mild form, no medical advice had been sought, and the cases
had remained undiagnosed, and were found on examination to be
disquamating; all were removed to Hospital.
There was no "return case" of Scarlet Fever during the year.
The preventive measures taken have been of the same
character as those carried out during 1921, details regarding these
will be found on reference to my Annual Report for that year
(page 23).