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97
Presumed Sources of Infection. In 9 instances the disease
was contracted from known, missed, or unrecognised cases in the
members of the patient's family. Two patients caught the
disease in hospital after they had been admitted suffering from
diseases other than diphtheria. These are called cross infections
and occur when a patient is being treated in hospital for one
disease, say, measles, or pneumonia, and contracts another
disease, e.g., scarlet fever or diphtheria from some other hospital
patient. Unfortunately, they occur in most fever hospitals, and
point to flaws in their internal administration. Three caught
diphtheria on visits to friends or relatives—seven on visits to
places of entertainment.
Eight were infected by school fellows or play fellows in the
same blocks of model buildings. Five developed the disease after
recent attacks of measles. The association between the two
diseases, measles and diphtheria, is often a close one. There
were no return cases.
Cases discharged cured from Hospitals.—A few days
after their arrival home from fever hospitals, all patients are
examined very carefully and a record kept of their condition. A
leaflet is given to the parents, its terms explained, and precautionary
measures are advised. If a child has a discharge from
the nose, or if for any other reason the infection is believed to
persist, the mother is advised to take the child to her own doctor,
or if poor to bring it to the public health department. The conditions
tfound amongst these convalescent patients after their
return home are shown below:—
Neck Glands enlarged 13
Nasal Discharge 15
Sore Nostrils 2
Ear Discharge 1
Sores on face or ears 2
Anaemia 11
Sore Throat 1
Squint 1
Difficulty of swallowing 2
Vomiting 1
Weakness of limbs, probably
slight paralysis
following diphtheria 11
Shortness of breath 5
It is quite possible that some of the cases in the above list were
discharged from hospital rather a little too soon.