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24
DIPHTHERIA.
case—not that between last contact and onset of secondary case. On the hypothesis stated, 26 out
of the 35 cases would be attributable to personal contact.
As regards the other cases, it can only be said that the two cases which occurred in Ward I.
(Queen's Park) at an interval of 12 months were, in all probability, quite independent of each
other; that the two at seven months' interval (same Ward) occurred in two families, and were also
probably independent of each other; that the same may be said of the two cases at three months'
interval in Ward III. (Maida Yale), the first case having been home from hospital for a month
before the second patient sickened; that the two cases at three months' interval in Ward Y.
(Church) were in two families, and also probably distinct infections; and that the two cases in
Ward IV. (Westbourne), with two months' interval, although in the same family, appeared from the
histories obtained to be due to distinct importations from outside London.

In one case only was the primary patient kept at home, Case (d) in Ward I., the patient dying
on the day the case was reported.
Three cases were not explainable by direct personal infection:—
Ward I., Case (b).—The third case occurred in a second family, the patient attending an
infected school up to the day of the onset of the disease.
Ward II., Case (b).—The same explanation holds good here, except that there was less chance
of infection at the school.
Ward VIII.—The second and third cases followed the return home of the first case, and were
probably due to that fact.
Household with fire rases during the year—
In this case the intervals could not be ascertained. The patients, with one exception, were very
slightly ill, and the disease was only recognized by bacteriological test. Four of the five patients
were attending school until stopped for the test. None of the patients went to hospital.