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more careful, told me was almost certainly diphtheria. A few days
afterwards, other deaths occurred in Inver Road, Aveley Road, and
Stone's Buildings. Unfortunately, just after the outbreak, a house
drain was opened in the Inver Road, so that the spread of the
disease might have been affected by it. Many of the cases
occurred, and some died nearly a week before the opening of the
drain. The measures taken to prevent the spread of the disease
were to prevent children attending the school from infected houses,
and have all children sent home without entering the playground.
The effects of these measures were very marked without closing
the school.
Outbreaks of sore throat spreading through the houses are by
no means rare, but they seem to spread in the same way as diphtheria,
viz., personal contact, so that the same precautions as
regards isolation obtain in each case.
Typhoid Fever.—On July 27th I received certificates that
five cases of typhoid fever had occurred in one street in Dalston,
and one in an adjoining street; on the 28th, of three cases in one
house in another street; and on the 29th, of three more cases in an
adjoining street. On making personal enquiry I found that fen of
the twelve children had been on excursions on July 7th and 9th to
the Forest. I went to the places where they had tea, and ascertained
that the water supply was good, that a very large number
of other children had been there on the same day, and that no
general outbreak had occurred. Also that there was not any
typhoid anywhere in the tea-gardens. I then obtained lists of the
houses supplied by the milkman who sold most of the milk in the
street, and ascertained that numerous other persons were supplied
by him out of the same can, who did not suffer. I was unable,
therefore, to decide as to the cause of the outbreak, especially as
there were other instances of outbreaks in other streets, where the
children were affected at the same time, and who did not go on
excursions. A few more cases occurred subsequently in these
streets which were evidently from infection by those first attacked.