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children attending this school being notified between the 2nd and 17th
June. As the result of the inquiries made and precautions taken, there
was no further spread of the disease after the 17th June.
Diphtheria.—In 1908, 138 cases of diphtheria (including 3 of
membranous croup) were notified in Chelsea, equivalent to a case-rate of
181 per 10,000, as compared with 21.1 in 1907. In the first quarter
of the year 33 cases were notified, in the second quarter 22, in the third
quarter 35, and in the fourth quarter 48. The percentage of cases of
school ages (3 to 13 years) of the total number in the Borough was 70,
as against 72 per cent. in 1907. In North Chelsea 66 cases were notified,
and in South Chelsea 72.
The influence of school closure in August upon the prevalence of
the disease was not apparent, as very few cases were occurring in
the spring and summer. Eight cases were notified from the Duke of
York's School in October, and 2 in November. Prophylactic precautions
were taken by the Medical Officer of the School, similar to those set out
in my Annual Report for 1906, with the result that what threatened to
be an explosive outbreak was completely prevented. This is the second
time within two years that the school has been seriously threatened with
epidemic diphtheria; and these occurrences tend much to emphasize the
necessity for the removal of the school from the existing inadequate
buildings to the new premises on Dover cliffs. The removal of the
school and the closure of the existing buildings for school purposes will
be carried out during the current year (1909).
Special school incidence was also shown in respect of three elementary
schools during the course of the year, namely:-Ashburnham School,
3 cases in June; Hortensia-road School, 4 cases in September; and Parkwalk
School, 4 cases also in September. The action taken in respect of
these cases was effective in preventing any further extension of the
disease in any of the schools affected.
The average duration of stay in hospital of 94 cases, of which the
records are to hand, was 53 days, as against 52 in 1907. Nine cases
admitted during the year to the M.A.B. hospitals were subsequently
certified by the Medical Superintendents of these institutions not to be
suffering from diphtheria or any other notifiable disease, the corresponding
number in 1907 being 14. The average duration of the stay in hospital
of these 9 cases was 21 days, as against 19 in 1907. Four cases of
diphtheria on discharge from M.A.B. hospitals were stated to be still
suffering from rhinorrhcea, but free from diphtheria bacilli.
During the year medical practitioners sent 60 throat swabbings to
the Lister Institute for bacterioscopic diagnosis, the costs being defrayed
by the Borough Council. Forty-four of these swabs were sent by the
medical staff of the Victoria Hospital in respect of Chelsea children. Of
the total of 60 swabbings, 22, or 36 6 per cent., afforded positive evidence
of the presence of the specific diphtheria bacillus, and 38, or 63.3 per cent.,
gave negative evidence. One out of the 22 "positive" swabbings also
showed the presence of Hoffman's pseudo-diphtheria bacillus, and 7 of
the "negative" swabbings contained this bacillus.