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72
Outbreak of Diphtheria at the Wandsworth Infirmary
St. Johns Hill, January to May, 1908,
An outbreak of Diphtheria occurred at the Infirmary, St.
John's Hill, which is under the control of the Wandsworth
Guardians, during the months of January, February, March,
April and May, 1908. The outbreak was characterised, in the
majority of the cases by the mildness of the type of infection, a
large number of the patients notified presenting little or no
apparent clinical evidence of the disease, yet presenting, in the
swabs taken from their throats or noses, bacteriological evidence
of the presence of the Klebs-Loeffler bacillus, the Specific Germ
generally recognised as associated with the disease. This fact
gave rise to considerable difficulty in dealing with the outbreak,
necessitating, as it did, the taking of a vast number of swabs
from the throats or noses of "suspects" (i.e., persons presenting
doubtful diphtheria symptoms) and "contacts" (i.e., persons who
had been in contact with genuine Diphtheria). These bacteriological
examinations were carried out, in the majority of instances,
at the expense of the Borough Council, but a considerable number
of examinations were also carried out for the Guardians by
an independent bacteriologist, the results in most cases confirming
those obtained by the bacteriologists employed by the Borough
Council. The latter course was considered advisable, as some
difficulty (which, happily, was later overcome when the difficulties
associated with isolation of cases at the Infirmary was recognised)
arose with the Metropolitan Asylums Board Hospital Authorities
in connection with some of the children who, by order of the
Medical Superintendent of the Infirmary, were sent to the Board's
Hospital for isolation purposes, although such children appeared
at the time to show no clinical evidence of the disease, but who
showed, on bacteriological examination of swabs taken from their
noses or throats (or both), the presence of the Klebs-Loeffler
Bacilli. The removal of these cases was rendered absolutely
necessary owing to the overcrowded state of the Infirmary, and
the absence of even the most elementary means of isolation. To
retain these cases, under the circumstances, in the Infirmary would
have been to invite disaster, as it is well known that these