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person of a boy aged 6 years. This boy remained at home until the 24th
October, when swabs of both throat and nose proving "positive," he was
notified and removed to hospital. The throat of a brother of this
"carrier " was examined with negative results, but the Hoffman pseudodiphtheria
bacillus was present. This brother continued to attend the
Boys' School until the "carrier'' was notified. Although this "carrier"
did not infect his brother, he was the means of infecting a little boy,
aged 4 years, who lived on the opposite side of the street, and with whom
he played when out-of-doors. The little boy of 4 years did not attend
any school.
In connection with this outbreak there was also another "carrier"
case, who was the means of infecting a child living in the same house,
although her own family escaped. This "carrier" was a girl of 5 years,
who was excluded from school on the 14th October on account of
symptoms of "cold," no bacteriological examination at that time being
made. On the 1st November, a little boy of 2 years living in the same
house as that occupied by the "carrier," with whom he was in the habit
of playing, was notified as suffering from diphtheria. A swab of the nose
of the "carrier'' case was then taken, and, on proving positive, the
"carrier" was notified and removed to hospital. A swab taken at the
time of the brother of the "carrier " proved negative.
In October, 1909, six cases of diphtheria had occurred in the Infants'
Department of the Christchurch School, and the attention of the
Managers of the school was then called to the defective ventilation of the
class-rooms. In one class-room, of the entire wall-window area only one
quarter could be opened, whereas the proportion should be at least onehalf,
the result being that in warm weather the school was very stuffy
from insufficient supply of air, whilst at all times of the year it was
difficult to flush the room with fresh air, as should be done when the
children are out of school. My report, with specific recommendations
for the improvement of the ventilation, appears to have been forwarded
in October or November, 1909, to the Education Department of the
London County Council, but no further action was taken. On the
recurrence of diphtheria in the school in October, 1910, I again called the
attention of the Managers to the defective conditions still existing, and I
am pleased to record that the matter was promptly taken in hand and
new ventilators inserted as suggested, so that at the present time the
proper ventilation of the class-rooms can be maintained.
Holy Trinity School.—Four cases of diphtheria were notified amongst
girls attending the Girls' Department between the 14th and 21st October.
The usual steps were taken to exclude children presenting suspicious
symptoms, with the result that there was no extension of the disease.
The utility of the London County Council's regulation requiring that
children who have been excluded from school on account of sore throat,
or have been absent from school for similar illness, should not be allowed
to return to school, when diphtheria has shown its presence in the school,
until a negative result has been obtained by bacteriological examination,
is exemplified in the following instance:—A little girl of 10 years ceased
attending school on the 27th October, owing to a sore throat. She was
attended by a doctor, and on the 11th November had apparently
recovered sufficiently to return to school; but a bacteriological examination
then made showed that that the diphtheria bacillus was present in