Annual report for 1894 of the Medical Officer of Health.

  • Chelsea (London, England). Parish. Vestry.
Date:
1895
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Annual report for 1894 of the Medical Officer of Health. Source: Wellcome Collection.

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    11 notifications of diphtheria occurring in children of school-age (3 to 13 years) have suddenly undergone a very considerable reduction during the period of the summer holidays, when the schools have been closed, but have increased again very largely in the week following the re-opening of the schools—the incidence of the disease upon children under 3 years, and upon persons over 13 years being comparatively unaffected by school closure. Recent research has shown that the specific organism of diphtheria—the Loeffler bacillus—may be found in the throat secretions of patients convalescent from this disease for very considerable periods after the disappearance of all symptoms, and at a time when the patient is to all appearances completely recovered. The specific organism has also been found in the throats of those who are apparently suffering from simple tonsillar inflammation, without any diagnostic sign of diphtheria being present. It is highly probable that wherever the virulent organism is present, there is a real danger of infection being imparted ; and such facts as these show that the problem of the prevention of diphtheria is one attended with many grave difficulties. It is understood that the method of bacteriological diagnosis of cases admitted as diphtheria is now being extensively employed at the Metropolitan Asylums Board Fever Hospitals, and that convalescents from this disease are not permitted to return to their homes until a bacteriological examination has shown that the diphtheria bacillus is no longer to be found in the secretions of the patient. Such a precaution as this was urgently necessary, and is likely to be productive of much good. The larger question of the establishment by municipal means of a system of gratuitous bacteriological examination in aid of the diagnosis of medical practitioners throughout London is still under consideration. Typhoid. Fever showed a slight increase in 1894 over that observed in 1893. As usual, the greatest prevalence was in the last four months of the year, 43 out of the total of 85 cases occurring in the home district having been notified in these months. Only two cases of this disease were notified in August, whereas twelve were brought to the knowledge of the department in September. It is probable that a considerable percentage of the September cases contracted the infection outside Chelsea, when away for their annual holidays. In Kensal Town in 1894 there were 79 notifications of scarlet fever, 41 of diphtheria, and 10 of enteric fever. In proportion to its population Kensal Town's share of the total Chelsea notifications was, scarlet fever 77, diphtheria 59, and enteric fever 23; thus showing that whilst scarlet fever prevailed relatively to the same extent in Kensal Town as in the home district, the former district suffered less from diphtheria, and very much less from enteric fever than the home district. The following Table IX. shows the case mortality, or percentage of deaths to notifications, of scarlet fever, diphtheria, and enteric fever in Chelsea and in London for each of the five years 1890-4.
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