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36
removed to hospital, where she died of the disease. There appears
to be little doubt that this is the link connecting the two outbreaks,
one in each school.
The six cases at Moreland Street School were followed by four
others, each of wliom contracted Diphtheria from the previous
cases in the school. There were therefore ten cases in each school,
the Brewer Street School cases being evidently started by cross
infection from Moreland Street School.
It shoidd however be noted that directly our attention was
called to the presence of Diphtheria at Brewer Street School,
a careful inspection of the school was made, and the urinal and
trough closets were found to be in a most unsatisfactory and
unclean condition, and the drainage of the school was found to be
defective. There is however little doubt that this was not the
direct source of infection.
It is needless to add that the record of relationship set out
above was only revealed after the cases had occurred. Directly
the first cases occurred thorough disinfection took place in 18
houses infected. Brewer Street School was inspected, a list of
of the children made, visits paid on those absent through illness,
and the school was closed on February 20th (after the first three
cases), and disinfected throughout. The school remained closed for
some three weeks during the renovation of the drainage.
The fact that in 13 families infected in this series of school
cases only one patient was attacked, is an indication of the success
following the rapid isolation and thorough disinfection practised
in each case. There can be little doubt that the measures carried
out prevented a wide-spread outbreak of the disease.
Bacteriological Diagnosis has been taken advantage of
in 61 cases of Diphtheria. Of these, 13 proved to be positive,
and 48 gave a negative result.
The Bacteriological Diagnosis is used only in doubtful cases.
If the case is one showing the ordinary clinical signs of