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There seems little doubt that E.W. infected both the child who died and the school girl in her own
class, and if this be so then she again became capable of conveying infection four and a half months
after the onset of the original attack of diphtheria.
As already mentioned the action taken in dealing with this outbreak consisted in the closing
of two rooms on December 6th, and the examination of all the children in the affected classes either
at school or at home. The closed rooms were re-opened on December 11th, and although the
permission to re-open was at the time criticised no further cases occurred among the children in
these classes. In the infant's class one case occurred on December 12th, and one after the Christmas
holidays was notified on January 13th. Outside the school the epidemic did not spread from
house to house and with the exception of the first cases in Rooms A and Al, and one case in the
Infants' class, all were accounted for by the orphanage outbreak or by the spread of infection among
members of the same family. In the course of the outbreak 44 children were examined bacteriologically
in their own homes or at the Town Hall in addition to the number examined in school by
the school medical inspector. Of those examined outside the school five proved to be carrying
diphtheria bacilli in their throats.
The following table shows the number of cases of diphtheria and the mortality during 1911 and
in previous years.

From the figures given it will be seen that the disease has not been unduly severe in type, since
the case fatality did not exceed ten deaths per hundred cases. The total number of cases notified
has been considerably above the average, though less than the numbers notified in 1901, 1907 and
1908.
SCARLET FEVER.
During the year 227 cases of Scarlet Fever were notified, and of these only 3 proved fatal.
The seasonal incidence of the disease is shown in the following table:—