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82
later he was removed suffering from Diphtheria, suggests that it
was from him that Nurse G— contracted the disease, and
that he may also have been the medium by which the children in
Livingstone Ward contracted the disease.
The case of Nurse B— is peculiar. She had been engaged
as a probationer Nurse in Ward III., "B" Block, up to
the 27th April, 1908. She had been swabbed two or three times
while in the infected zone, but with negative results. She was
transferred (27th April) to "C" Block for a day or two, and then
to a different sphere of duty in another part of the building. She
developed clinical Diphtheria, and was notified and removed to
the Metropolitan Asylums Board Hospital on the 13th May. It is
possible, if not probable, that she was suffering from the disease
in a latent form during the time she was in the infected zone in
" B " Block.
Preventive Measures Taken.
The preventive measures taken in connection with the outbreak
were (1) notification, (2) isolation, (3) disinfection, (4) medical
inspection of all "suspects" and "contacts," and (5) anti-toxin.
Bacteriological examinations were found absolutely essential as
an aid to notification and medical inspection. These examinations
were systematically carried out, and resulted in the gradual
elimination of all Diphtheria cases (clinical or bacteriological), and
the exclusion of cases, and segregation in the Isolation Ward,
which, by the action of the Guardians in removing a large number
of adult patients to other Institutions under their control, was
possible at length to obtain. All these pseudo-diphtheria cases
were put into this Ward, and not allowed to return to the other
Wards of the Infirmary until after consecutive bacteriological
tests had given negative results
The Infirmary was placed in quarantine, visits of patients'
friends being entirely stopped. The overcrowding, which was at
first such a regrettable feature, was gradually abated, a large
number of adults, mostly chronic infirm cases, being sent to the