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28
Annual Report of the London County Council, 1911.
DiphtheriaIncidence
in
relation to
school
attendance.
In connection with the question of the redaction in the prevalence of the disease among persons
of school age during the summer holiday when the schools are closed it has been thought well to
include, as in previous reports, the following table. The summer holiday of the schools of the London
County Council began on Thursday, the 27th July, i.e., the latter part of the 30th week, and the
schools re-opened on Monday, the 28th August, i.e., at the beginning of the 35th week.

Bacteric
logical
diagnosis.

From the annual reports of medical officers of health, it appears that there was no considerable
outbreak of the disease during the year; although the Hampstead report refers to an unusual prevalence
of high infectivity. In several of the reports reference is made to a special incidence upon school
children, amounting in Wandswrorth to 46 per cent. of the total number of cases. The medical officer
of health of Greenwich comments upon the insidious nature of the complaint and mentions the exclusion
from school of children actively infectious, but having symptoms only of cold in the head, with slight
nasal discharge. In the Kensington report details are given of particular cases illustrative of the
difficulty of diagnosis, and the length of the infective period, whilst the medical officer of health of Chelsea
gives an account of a school outbreak where 6 cases are ascribed to contact with a "chronic carrier''
whose father died of membranous croup.
The result of inquiry into the source of infection is shown in some of the reports as follows:—
Paddington, of 152 cases, 7 were contracted in hospital after scarlet fever; there were 29 secondary
cases, and 3 return cases; Finsbury, of 159 cases, 10 were due to infection by members of the same
family; 8 were infected by previous cases in the same house or near by; 8 were infected in hospital, and
2 while visiting relatives, 6 were return cases; Bermondsey, of 260 cases 13 were due to previous
cases in house or family; in Woolwich, of 204 cases, there were 29 infected by other inmates of
the house; 16 were attributed to school infection, 3 to infection by neighbours and friends, 4 to
ordinary hospitals, and 11 to fever hospitals, 1 was a return case.
Some of the reports give the number of houses where more than one case of the disease occurred.
Thus in Paddington, multiple cases occurred in 14 houses, including 1 house with 4 cases. In Fulham,
there were 27 houses with multiple cases amongst the 274 houses invaded. One of these had 5 cases.
In Westminster 1 house had 4 cases, 1 house had 3, and 4 houses had 2 cases each. Hampstead had
2 families with 4 cases each, whilst in Holborn, there were 61 single cases, 3 houses with 3 cases each,
and 4 houses with 2 cases each.
In the report for 1910 reference was made to the Order of the Local Government Board, sanctioning
the supply of anti-toxin by local authorities. This subject is dealt with in some of the reports
of medical officers of health, two making mention of the fact that no applications were received, whilst
13 record the supply of anti-toxin for curative and prophylactic purposes.