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admitted during the year to the M.A.B. hospitals were subsequently
certified by the Medical Superintendents of those institutions not to be
suffering from diphtheria or any other notifiable disease, the
ponding number in 1910 being 4. The average duration of the stay in
hospital of these 5 cases was 19 days, as against 27 days in 1910. Two
cases of diphtheria on discharge from hospital were stated to be still
suffering from rhinorrhœa, but free from diphtheria bacilli. One case of
chronic otorrhœa was discharged. So far as is known, there was no
spread of infection from any of these cases after return to their homes.
During the year medical practitioners sent 105 throat swabbings to
the Lister Institute for bacterioscopic diagnosis, as compared with 122 in
1910, and 2 were sent from this department by myself, the entire cost
being defrayed by the Borough Council. Sixty-six of the swabs (62 per
cent, of the total) were sent by the medical staff of the Victoria Hospital
in respect of Chelsea children. Of the total of 107 swabbings, 31, or
29 per cent., afforded positive evidence of the presence of the specific
diphtheria bacillus, and 76, or 71 per cent., gave negative evidence.
These are practically the same proportions as in 1910. Eight of the
negative swabbings showed the presence of Hoffman's pseudo-diphtheria
bacillus.
No applications were made during the year by medical practitioners
for anti-toxin, or for repayments for the supply of anti-toxin by chemists
in the Borough for the use of the poorer class of patients prior to removal
to the fever hospitals.
School Outbreak of Diphtheria.—Special school incidence of
diphtheria was shown in respect of the Infants' Department of the
Cook's Ground School, six cases of the disease being notified amongst
children attending this Department between the 20th October and the
30th November, the dates of notification being 20th October, 8th, 14th,
24th, 27th, and 30th November. In addition, a child not attending
school, but one of a family where two brothers attending school were
attacked, was also found to be suffering from diphtheria on the 29th
November.
All these cases were probably due to the presence of a chronic
"carrier," a little girl of six years, who attended the infant department
of the school. On the 13th November the father of this child was
certified to be suffering from membranous croup, and he died the same
day at the M.A.B. hospital to which he was removed.
The little girl returned to school on the 29th November, and a
swab of her throat was taken on the 1st December by the school doctor,
other children of the class being swabbed at the same time. The little
girl's throat was the only one which gave a positive result as regards the
presence of the diphtheria bacillus, and she ceased attendance at school
on the 4th December. No further cases occurred amongst those
attending the school. On the 21st December a medical certificate was
received at the office stating that the child's throat had been swabbed,
and she was found to be no longer acting as a "carrier."
Enteric Fever.—The number of cases of enteric fever notified in
Chelsea in 1911 was 7, as against 16 in 1910, the case-rate being only
1.1 per 10,000 of the population. One case was notified in the first