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2. Those with nasal catarrh or mild pharyngitis, showing
evidence of the presence of Klebs-Loeffler bacillus on
bacteriological examination.
3. Those exhibiting no apparent clinical symptoms whatever
of the disease, but showing on bacteriological examination
the presence of the Klebs-Loeffler bacillus in the
secretions of the nose or throat (or both).
Details of the Outbreak.
The source of the outbreak at the Infirmary was, owing to
the difficulties to be presently described, impossible to definitely
trace. This is not, under the circumstances, a matter for reproach,
and while it is to be regretted that one cannot trace, link
by link, the means by which the disease gained access to the
Institution, it will be acknowledged that the difficulties of determining
this definitely were insurmountable.
The history of the outbreak is as follows:—On the 27th
December, 1907, a probationer nurse, named Margaret G—,
was notified as suffering from Diphtheria, the case having been
removed to the Metropolitan Asylums Board's Hospital on the
previous day. On the 14th January, 1908, a second case—
another nurse, Sister Eveline K—, was notified, and she was
removed to hospital the same day. In consequence of this second
case arising amongst the nursing staff at the Institution, there
appeared to be evidence pointing to infection taking place in the
Institution, and I at once put myself into communication with the
Medical Superintendent. As a result of the information supplied,
it was arranged to examine the children in the Ward (I.B. Block)
in which this nurse had been employed. Two of the children in
this Ward were found to be suffering from a nasal discharge, and
swabs were taken from each and bacteriologically examined. The
swab taken from one of these, a boy named Leonard N—, was
found to contain the Klebs-Loeffler bacillus, and the child was
at once removed to the Isolation Hospital.