Of 794 samples of baking powder analysed, 27 were reported against as being deficient in carbon dioxide or as containing traces of arsenic. Two samples of lemon crystals and one of bottled fruit were reported to contain minute particles of glass. Lead was found in 10 samples of aerated waters, one of orange squash, and one of tinned sardines. Many samples of spice contained siliceous matter. An article described as "Pure Raspberry Cordial was found to be devoid of genuine raspberry extract and its acidity to be due to phosphoric acid. 66 A coloured and flavoured solution of sugar in water was sold as Black Currant Wine" and the vendor was fined £15 and £3 3s. costs. The presence of boric acid was reported in many samples of sponge cake and Swiss roll. Copper was found in two samples of aerated water, and in 30 samples of tinned peas, French beans and mixed vegetables. A consignment of smelts from the Continent was found on examination to contain a large amount of boric acid. The consignment was destroyed and the vendors ceased importing similar fish from the same source. Drugs. During 1927, 4,981 samples of 120 different varieties of drugs were examined and 283 or 5.7 per cent. were found to be adulterated or not up to standard, compared with 5,287 samples, of which 236 or 4.5 per cent. were adulterated, in 1926. The most interesting case was that of some Cod Liver Extract Tablets which were sold by a well-known firm of druggists and advertised as being rich in vitamins A and D. The Analyst reported that so far as he could discover by chemical tests he was of opinion that vitamin A was present, if at all, in such a negligible amount as to render the tablets practically valueless as a substitute for cod liver oil. The deficiency of both vitamins was confirmed by biological experiments and the vendors were convicted and fined £30 and £75 costs. Infectious Diseases. GENERAL. Principal Notifiable Diseases. The following table shows for each of the years 1924 to 1927 : (a) The total number of cases of each of the principal infectious diseases (except tuberculosis) which are notifiable 1970 B 2 throughout England and Wales, excluding cases among noncivilians and those in which the notifications were subsequently withdrawn, but including small-pox cases which, although not notified, were discovered and communicated to the Department; and (b) The total number of deaths registered from each disease, including deaths of members of the armed forces. (Acute Primary) Pneumonia 60,794 55,960 51,010 67,757 38,970 |||36,990 |||32,339 |||37,242 (Acute Influenzal), $8,545 5,172 $3,788 10,007 ** *Measles is not now generally notifiable. Broncho-pneumonia, lobar pneumonia, and pneumonia not otherwise defined. ††Puerperal Pyrexia became notifiable on the 1st October, 1926, and the number of cases for 1926 given in the table consequently relates only to the last three months of that year. ¶ Corrected figures. † See note on page 39. 84,450 888 988 677 579 14,787 8 6 11 +36 2 2 2 1 1 1 2 5 1 The number of deaths and the death-rates in England and Wales from the principal infectious diseases, in successive decennial periods from 1871-80 onwards and in 1927, are shown in the following table : Comparable figures for the decennia before 1911-20 are not available. + See note on page 39. 715 0.019 430 0.011 18,401 0.512 6,197 0.158 5,058 0.141 2,732 0.070 1,278 0.035 367 0.009 21,641 0.590 22,263 0.567 9,868 0.275 3,622 0.092 1,184 0.033 140.000 5 0.000 112 0.003 1,026 0.026 579 0.015 +36 0.000 6,538 0.183 3,681 0.094 Note. In the case of some of these diseases the figures for recent years are not strictly comparable with those for the preceding decades, owing to the changes in nomenclature and classification due to increased knowledge of the disease and improved diagnosis. For the years 1915-20 the death-rates, but not the numbers of deaths, relate to civilians only. The outstanding features of the year were the continued prevalence of mild small-pox, and a considerable decline in the fatality rate for scarlet fever and diphtheria. In the case of each of those diseases, the rate was the lowest recorded since complete returns became available in 1911. The number of cases of encephalitis lethargica notified shows a progressive decline, but the fatality rate from this disease has increased. Scarlet Fever. 84,450 cases of scarlet fever were notified during 1927, as compared with 81,672 cases in 1926. But there were only 579 deaths from this disease, and the fatality rate decreased from 8.3 deaths per 1,000 notified cases in 1926 to 6.8 per 1,000 in 1927. Diphtheria. There was a small increase in the number of cases of diphtheria notified, the figures being 52,011 in 1927 as compared with 51,069 in 1926. But the fatality rate declined from 58.6 per 1,000 cases in 1926 to 52.5 per 1,000 in 1927. From information received by the Department, it appears that greater use is being made of the Schick test and of the immunization of persons against diphtheria. 1970 B 3 Encephalitis Lethargica. During 1927 the number of notified cases of this disease showed a further decline, being 1,615 as compared with 2,267 in the previous year. The fatality rate, however, reached the high figure of 71.5 per cent., as compared with 58.4 per cent. in 1926. Reference has been made in previous reports to the experimental unit established by the Metropolitan Asylums Board at Winchmore Hill for the treatment of the after-effects of encephalitis lethargica. In their report on the second year's working of the unit, the Asylums Board state that, although the unit has not so far been productive of any positive curative results, it has proved very valuable as an observation station where cases may be investigated and classified. It was found that the accommodation provided in this unit was not always fully occupied by London cases, and approval has been given to the reception of cases from other areas, on the understanding that nothing would be done to render it difficult to admit suitable cases from the Metropolitan area. During the year the Mental Deficiency Act, 1927, became operative. By amending the definition of "Mental Deficiency, this Act facilitates the treatment in Institutions for the Mentally Defective of suitable cases of persons suffering from the after-effects of encephalitis lethargica. Poliomyelitis and Polio-encephalitis. 896 cases of these allied diseases were notified during 1927, with a fatality rate of 20.3 per cent., as compared with 1,297 cases and a mortality rate of 18.1 per cent. in 1926. The only considerable outbreak was that which occurred at Hull in August, when 110 cases were notified, 6 of which were fatal. It is noteworthy that, although 94 of the cases were those of children under 10 years of age, all the deaths with one exception occurred in persons over that age. Plague. No case of plague was notified during the year under review. Rheumatism. During the year Regulations were issued under Section 130 of the Public Health Act, 1875, as applied by Section 113 of the Public Health (London) Act, 1891, making acute rheumatism in children under 16 years of age compulsorily notifiable in the Metropolitan Borough of Paddington for a further period of two years from the 1st April, 1928. Similar Regulations have been issued with respect to the Royal Borough of Kensington, and are to continue in force for three years from the 1st October, 1927. These Regulations empower the Borough Council to establish a Rheumatism Supervisory Centre, and to make such other arrangements as they think necessary or desirable for the supervision, after-care, and treatment of cases of acute rheumatism in the district. Plans for the extension of one of the Hospitals belonging to the Metropolitan Asylums Board, which was referred to in last year's Report, have now been approved. This extension will provide accommodation for about 350 cases of rheumatism in children, and the work is now in progress. Small-pox. The incidence of small-pox in England and Wales again showed a considerable increase in 1927, the number of cases being 14,787, as compared with 10,141 in 1926, and 5,354 in 1925. The Counties chiefly affected were Durham (6,446 cases), West Riding of Yorkshire (3,244 cases) and Monmouthshire (1,907) cases). The South of England remained comparatively free, but 515 cases occurred in Wales (apart from Monmouthshire), of which 455 were in the County of Glamorgan. The sanitary districts with the greatest incidence were the County Borough of South Shields (960 cases), the Urban District of Abersychan (898 cases), the City of Sheffield (666 cases), and the Rural District of Chester-le-Street (648 cases). The type of disease generally prevalent remained mild, but 49* deaths occurred in respect of which small-pox was entered on the death certificate as the cause, or one of the causes of death. In 36 instances, small-pox was entered as the sole, primary or immediate cause of death, or as a morbid condition giving rise to the immediate cause. Difficulty in combating small-pox is still caused by the reluctance of many persons to accept vaccination, and, owing to the prevalence of the mild form of the disease, cases of small-pox are sometimes overlooked or diagnosed as chicken-pox. A considerable number of Local Authorities have in consequence made chicken-pox notiable under the Infectious Disease (Notification) Act, 1889, with a view to bringing cases of this disease under expert medical observation at an early stage. Difficulty has also been experienced in some districts in securing the necessary hospital accommodation, and in others the cost of dealing with the epidemic continues to impose a serious burden on the local rates. Vaccination During the year 1926, the latest for which complete information is at present available, the number of births registered according to the Vaccination Officers' returns was 694,859. Of these children 311,142, or 44.8 per cent. of the total, were successfully vaccinated, * For full particulars see the Report of the Chief Medical Officer for 1927. 1970 B 4 |