View report page

44
Of these cases, 294 were primary. 46 were eases of secondary
infection, resulting from 39 primary cases. In 18 instances, the
primary gave rise to one case ; eight primaries gave rise to two
secondaries each and one each to three, four and five eases. In
one instance the primary case was one of nasal diphtheria and in
three the primary case was undiagnosed. In the others there
was much delay before the infecting ease was removed to hospital.
In less than a quarter of the eases was the primary case removed
before the fourth day from the alleged onset of the illness.
There were 10 return cases, one each from 10 infecting cases.
Only three of these primary cases were removed to hospital before
the third day from the alleged onset, the remainder having been at
home from varying periods over four days before removal. Two
were discharged before four weeks in hospital, two in the fifth and
two in the sixth weeks ; the remainder were in for longer periods.
In five of the return eases, the onset was within one week of the
return home of the infecting patients, one in the second and two in
the third. None of the infecting cases showed any abnormality
of the mucosa and in no case was a positive swab obtained.
Death Rate.
29 deaths (12 male, 17 female) occurred from diphtheria in
the course of the year, being a ease mortality rate of 7.5 %
01 these fatal eases two suffered from laryngeal involvement, one
following whooping cough. The other was a case of croup and
quinsy, which died at home. In five cases the child was removed
to hospital on the second day, and in four cases on the third day
from the onset of the illness. Considering the insidiousncss of the
onset of this infection, particularly in small children, it is extremely
unlikely that the history obtained gave the true time of onset of
infection, the probability being that most of these cases had been
absorbing toxin for a period considerably longer than that given
by the history.
Schick Testing and Immunisation.
fowards the end of the year, a number of children were Schick
and immunised. The advantages of the process are brought
to the notice of the mothers at the Infant Welfare Centres. Also,
on theoccurrence of a case of diphtheria, the Sanitary Inspector,
on his visit to the home, leaves an instructional leaflet and a form
which the parents can signify their desire to have the treatment
carried out. In one of the small infant schools, a few cases of
diptheria occurred from a primary nasal infection. Opportunity
as taken of this to inform the parents of the scholars of the
procedure with the result that some 30% consents were obtained.