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195
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September, October, and November. In all, 440 cases were
notified as compared with 303 last year. 188 of these were
removed to Hospital where 11 died, 252 were treated at home
with 3 deaths, giving a total case mortality of 3.2 per cent.
There is a very great difference in the case mortality of Hospital
as compared with home-treated cases, the former being nearly
5.9 per cent., while the latter was only 1.18 per cent. This
difference is to some extent due to the greater severity of the
cases removed to Hospital.
Diphtheria. 151 cases were notified, and 34 of these were
removed to Hospital. Of the hospital cases 9 died or 26.4 per
cent., while of the cases treated at home 20 died or 17.2 per cent.,
the total case mortality being 19.3 per cent.
The number of deaths at home is 7.8 above the corrected
decennial average.
This disease shows a decided increase, not only in this district,
but over the whole Metropolitan area.
As it is such a very fatal disease, the most fatal to young
persons, it is necessary that every precaution be taken to prevent
its spread. There can be little doubt that the aggregation of
children in public elementary schools plays a large part in its spread.
That this is the case in other zymotic diseases as measles and
scarlet fever, it has been conclusively proved, and as direct
infection from case to case plays the most important part in
diphtheria, there seems no reason to doubt that the latter also is
spread by means of schools.
In this regard the following statistics are interesting, and it will
be ssen that by far the larger number of cases occur at school
ages, i.e., from 5 to 15.