View report page

12
From a consideration of the course of this outbreak, I am led to believe
that the disease was introduced by some one of the work-girls ; that it was
spread amongst them mainly by contact—by the use of the four speakingtubes
and of the same towels in the lavatory. The following facts will, I
think, establish this contention.
The first case to be notified to me was that of L. J., on the fourth of
June, who left her work on the second, feeling too ill to remain. The next
notified were N. K. and R. J. on the thirteenth, the latter being sister to L. J.
These three all worked together side by side at the same table in the small
cutting room referred to above, and, with the forewoman, were the only
persons working there. These girls were particularly well situated to contract
an infection from one another should it be introduced. Outside the cuttingroom,
and in the main work-room, were the speaking-tubes. Although these
tubes were used at times by every one of the work-girls, they were mostly used
by the three work-girls mentioned above—one reason being they were the
nearest workers to the tubes, and being specially under the direction of the
forewoman, messages would most conveniently be sent and received by them.
Thus there were present all the necessary elements for the spread of diphtheritic
infection. Sitting side by side during the early stages of the disease, N. K.
and R. J., in all probability, caught the infection from L. J., and they also
innocently contributed to the dissemination of the disease, in the manner
described below.
Supposing one, or all of these girls, suffering from diphtheria in its early
stages, frequently pressed the mouthpieces of these speaking-tubes to their
lips, these mouthpieces would be capable of conveying the disease to other
healthy persons using them ; and this is, in my opinion, one means by which
the disease was conveyed to other workers; another being the towels in the
lavatory, which were used in common by the work-girls.
In confirmation of the above view, I must refer to the earlier part of the
report, in which I state that only one of the shop assistants on the ground
floor suffered from sore throat. I learned, on inquiry, that it was the special
duty of this assistant to answer the speaking-tube communicating with the
affected workroom. Whether the tube had become infected throughout its
whole length, and so conveyed the infection to this assistant, or whether her
illness was a coincidence, I cannot be certain; but I do think the incident
significant, and confirmatory of the above views.
I also mentioned two assistants employed on the first floor as suffering
from sore throat. I was informed that these two had been accustomed,
contrary to the rules of the establishment, to use the lavatory reserved for
the work-girls, and had, at such times, called in to speak with different workgirls,
thus exposing themselves to two sources of infection, viz. the infected
lavatory towels and such of the workers suffering from the disease in a mild
and unrecognized form.
Conclusions.—(1.) I am of opinion that the disease was introduced into the
workroom by one of the workers, and that the infection spread to the
others in the manner above stated. (2.) There were certain sanitary