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infection; in 175 of the 387 cases no definite clue could be obtained.
In the remaining 212, infection was traced to—
Cases in the neighbourhood in 64 instances
Cases in the house or family in 66 instances
Cases in the school in 62 instances
Cases convalescing from the disease in 6 instances
Other sources in 11 instances.
With regard to the family cases, it may be noted that in 33
instances 2 were infected; in 7 instances, 3, and in 2 others 4. The
person first attacked was supposed to have been infected from
neighbouring cases in 9 instances; at school in 12; and elsewhere
in 2 instances. In the remainder the source could not be traced.
In January and February a small outbreak of seven cases, which
occurred in St. Luke's Hospital, was investigated. The first notifications
were received on January 7th, and referred to two nurses employed
in one of the wards for female patients. Both were removed
to hospital, and disinfection of their sleeping rooms, etc., carried
out. The remaining notifications referred to patients in the ward,
and were received on January 8th (1); January 31st (2); and
February 3rd (2). All these patients were isolated in St. Luke's
Hospital. The discovery of the source of the outbreak was somewhat
complicated by the fact that for some time, in the ward concerned,
there had been a considerable number of cases of sore throat.
The source, in all probability, was one or other of the nurses first
notified. The precautions taken were the cutting off of communications
between the infected ward and the remainder of the hospital;
the isolation of the infected persons and disinfection. Examination
showed the existence of certain defects in the drainage system of
the hospital, which were remedied. After January 3rd, there were
no further cases, and the outbreak was limited to the one ward.
On page 126 an analysis of the notifications of infectious cases
received from the schools in the Borough will be found. In connection
with infectious diseases, several visits were paid to the schools; a
work which is carried on also by the medical officers of the London
County Council Education authority.