View report page

102
HISTORY OF A DIPHTHERIA OUTBREAK
AT THE LAMBETH PAROCHIAL SCHOOLS,
WEST NORWOOD, MAY—JULY, 1905.
(Special Report by Dr. Joseph Priestley, the Medical Officer
of Health.)
Introductory Remarks.
An outbreak of Diphtheria occurred during May, June and
July, 1905, amongst the children at the Lambeth Parochial
Schools, situated in Elder Road, West Norwood, and under the
control of the Lambeth Guardians. The majority of the cases
were of a mild (chiefly nasal) type, which gave rise to difficulties
not only in diagnosis but also in the adoption of the usual preventive
measures. The slightness, and, in some cases, the
apparent absence, of the well-known clinical symptoms of
diphtheria rendered it necessary to carry out minute and careful
bacteriological examinations, both of "suspects" (i.e., persons
presenting doubtful diphtheria symptoms), and of "contacts"
(i.e., persons who had been in contact with diphtheria), involving
a large amount of time and trouble. These bacteriological
examinations were all carried out in the Borough Laboratory
(the great value of which has been again proved), and the results
were afterwards, in every instance, confirmed by one or two or even
(at times) three independent well-known bacteriologists. These
confirmatory examinations were thought to be advisable in view of
the fact that a number of children were, by order of the Medical
Officer of the Schools, sent away to the Metropolitan Asylums
Board Hospitals for isolation, although such children appeared
to be, at the time, clinically in good health, despite the proved
presence in theirthroatsor noses(or both)of the true Klebs-Lœffler
diphtheria bacilli. These potential or carrier diphtheria cases
caused much anxiety, as the children, though not, apparently,
suffering from diphtheria in the ordinary clinical sense, were
none the less capable of transferring the disease to others, who
might be more susceptible to diphtheria infection, and might,
consequently, suffer severely clinically. Their strict isolation,
therefore, away from the Schools, was deemed to be absolutely
necessary: indeed, had it not been for such strict isolation of all
"carrier," as well as other, cases, the outbreak would not have
been stamped out so effectively (and so quickly) as it was.
It is acknowledged by all experts that diphtheria, like other
infectious diseases, occurs clinically in varying degrees of