View report page

94
holidays, or the infection was traceable to another known cause,
such as a primary home infection. Of the remaining 404; in 271
cases there was no infection in that department of the school for at
least one week previously. In 59 instances, there was another
case in the same department in the previous week, and in 35
instances, there was another single case in the same department
in the same week (in five instances three cases occurring in the
same week). These cases, however, occurred in the same department,
not necessarily the same class—and departments number
up to 400 children, in nine or ten classes. Actually there was very
little grouping of cases sufficient to suggest a local focus of infection.
In no one week did more than three eases occur in any
department, and in two of these eases, there were other infections
in the preceding or succeeding weeks. Only one instance occurred
where there appeared to be a definite school infection. This
occurred in an infants' school of the old type of building, and the
infections in consecutive weeks were 1,1, 0, 3, 2. These followed
a missed case who attended school suffering from otorrhæa.
School infection played a slightly more prominent part in the
spread of diphtheria; though still only a very small one. 296
eases were of persons whose infection was apparently not through
school: whilst in the cases of 152 of the other 229 infections, the
school was free from infection for at least one week before. In
26 cases, there had been an infection in the preceding week, while
in 22 weeks there was more than one child succumbed in one
department. In some of these, a definite source of infection was
found. Twice within the 18 months the same school—an infants'
department of the old type building, having the old bench seating
accommodation, was infccted through a carrier, the number of
infections in succeeding weeks being 1, 0, 2, 1 and 1, 3. 1. In both
instances, no more cases appeared subsequent to the removal of
the earner. Although five eases occurred in one week in one
department, 3 in another and 2, 1, 3 cases in one department in
consecutive weeks in another school, the only definite school
infections found were those in the old school. These instances are
the only ones in which more than 2 cases of diphtheria occurred in
any department in any one week, and in only 4 cases did the
disease appear in any department for more than two consecutive
weeks.
School infection then contributed little to the incidence of
diseases and so accounted little for the excess.
(3) Shortage of Isolation Hospital accommodation acts in
more than one way. Firstly, it means a certain proportion of
cases being treated at home, with consequent risk of infection to
the remaining occupants. Secondly, owing to cases for admission
having to be selected, there is delay in the removal of those which