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34
Chickenpox.
During 1915 the London County Council made an Order (confirmed
by the Local Government Board), rendering cases of chickenpox
compulsorily notifiable throughout the Borough (and the rest
of the metropolis) from March 17th to June 30th. The reasons for
the issuing of the Order were (a) the danger of smallpox being introduced
through the medium of troops, refugees, &c., and (b) the difficulty
that arises at times in diagnosing as between smallpox (in one
of its many modified, forms) and chicken-pox. During this notifiable
period (3½ months) 473 cases of chickenpox were notified by medical
men—66 from March 17th to March 31st, and 407 from April 1st to
April 30th. The 473 notified cases occurred in 429 infected houses.
Diphtheria and Membranous Croup.
During 1915, 44 vials of antitoxin were distributed under the
Antitoxin Order, 1910, free of cost to medical practitioners practising
within the Borough. During 1915 an outbreak of diphtheria in
connection with a public institution was under investigation—a
total of 68 cases, 2 girls and 65 boys and 1 assistant matron of the
boys' department, extending over a period of three months. The
majority of the cases were bacteriological diphtheria, though many
shewed also the usual clinical symptoms. The type of the disease
was mild—only 1 death (a boy) occurring. The usual precautionary
measures were taken, viz., isolation of cases at hospital, bacteriological
examinations of contacts and suspects, examinations of water
and milk supplies, the use of antitoxin as a prophylactic, disinfection,
&c. After careful enquiries into the usual channels through
which diphtheria is spread, nothing was found satisfactorily to
explain the outbreak, but it was noted that cats were kept as pets at
the institution, and it was deemed advisable to make an examination
of the cats' throats and noses with a view to discovering if the
diphtheria germs were being transferred to the patients from such
animals or vice versa. There were 9 cats in all and 3 (belonging to
the boys' department) shewed the true diphtheria germ in their
throats or noses, 1 (belonging to the girls' department) the pseudodiphtheria
germ, whilst the remaining 5 proved negative in so far
as the diphtheria germ (true or pseudo) was concerned, but shewed
the presence of stephylococci and streptococci. These 5 cats were
connected with the girls' department (3), the laundry (1), and the
lodge (1). It is interesting to note that there were 3 infected
(diphtheria) cats found in the boys' department, which furnished
97 1 per cent. of the total cases comprising the outbreak, and in this
connection the superintendent reported that the boys were oftener
found to be fondling and playing with cats as pets than the girls.
There is still the doubt as to whether the cats infected the boys or
the boys the cats, but as an extra precautionary measure the cats
were all destroyed, and the outbreak afterwards ceased.