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13
You are doubtless aware that, throughout the whole
country, Medical Officers of Health are desirous of
obtaining a better control of epidemic disease, whether
Scarlet Fever, Measles, Whooping Cough, Diphtheria,
Mumps or Influenza, and yet all must admit that little
progress seems to have been made with these particular
complaints during the past few years, judging from their
prevalence.
With regard to Diphtheria, the following facts can
be stated with certainty (according to Dr. Rolleston,
and confirmed by others), viz.:—
(1). That in spite of all Public Health measures
relating to hygiene, isolation, improvement in diagnosis
and treatment, the incidence of diphtheria has
shown a tendency rather to increase, especially in
London during the past 15 years.
(2). That although no age is exempt, the
disease is commonest in childhood, particularly between
the ages of three and five, susceptibility
diminishing as age advances.
(3). That girls are more susceptible, and
women, because chiefly of their closer association
in nursing.
(4). That the anti-toxin treatment which at
first (1894) reduced the case mortality from 30 per
cent. to 10 per cent., has since 1904 only further
reduced it about 2 per cent.
(5). That the "carrier" is probably the chief
cause of the disease. (You remember when we
examined a school of several hundred children we
found no less than eight " carriers," whom we
isolated at once till rendered negative)., Dissemination
of the disease usually takes place by actual
contact, in sneezing, coughing, spluttering, spitting,
etc., but also, of course, by contact with clothing
and articles infected.
(6). That wounds are often infected with the
germ and occasionally in this way milk is contaminated
by the milker; otherwise food and drink are
not suspected as factors.