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the return home of a patient was followed two months after by the notification of
another case in the same family; swabs then taken from the original patient
proved nose positive and throat negative. A week later swabs of the throat and
nose of the original patient were negative.
In London, 13,411 cases were notified giving rise to 460 deaths.
We endeavour to co-operate with the Medical Superintendents of the Fever
Hospitals serving the County of London; information is now sent to them as to
any bacteriological examinations before admission or after discharge of the patients,
and also with regard to return cases of diphtheria or scarlet fever.
Diphtheria in Hospitals.
Information was received of 86 cases of diphtheria occurring among in-patients,
or staffs at three hospitals in the Borough.
The information was obtained from the notifications of removal received from
the London County Council, or from the ordinary notification certificates furnished
by the doctors diagnosing the disease.
From one hospital there were 64 notifications of which 53 were clinical cases
(33 were notified "nasal") and 11 were notified as "carriers" only. Of these
64 notifications six related to Holborn residents, namely, four nurses and one ward
maid at the hospital and one in-patient admitted to the institution from a home
address in the Borough. Fifty-eight were in-patients admitted from areas outside
the Holborn Borough. Copies of the notifications of these cases if sent to the
Holborn Public Health Department are forwarded to the Medical Officers of Health
of the districts from which the patients were admitted. Information kindly
furnished by the hospital indicated that in nine cases the disease was contracted
prior to admission to the institution; in 39 the disease might be regarded as
contracted after admission; in five definite information as to the time or source of
infection was not available.
From a second hospital eight cases were removed, three nurses and five inpatients
(two of whom were notified as "nasat diphtheria"). In addition to the
three nurses three of the five in-patients were also Holborn residents; the other two
in-patients had been admitted from outside the Holborn area.
From a third hospital 14 cases were removed, two were nurses (one male, one
female), three were ward maids (one of whom was notified as a carrier) and nine
were in-patients. All the in-patients had been admitted to the hospital from
outside the Holborn area.

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