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were: — Borough, 327 ; Bermondsey, 210 ; Rotherhithe, 72, and St. Olave's, 45. This is
satisfactory, since, while diphtheria has increased in London generally, in Bermondsey there is
a decrease.
Year.
London.
Bermondsey.
1892
8,368
161
1893
13,712
367
1894
11,204
446
1895
11,231
281
1896
13,825
425
1897
13,217
393
1898
11,883
326
1899
13,711
734
1900
12,023
471
1901
12,156
329
1902
10,731
277
1903
7,738
172
1904
7,219
191
1905
6,482
165
1906
8,041
327
1907
8,779
311
Average
10,645
336
The attack rate per thousand inhabitants was 2.4 against 2.5 in 1906. The case
mortality was 7.1 per cent. against 10.3 per cent. in 1906, and 10.9 per cent. in 1905. 37 cases
were returned as not suffering from this disease.
257 specimens were sent in by medical practitioners for bacteriological examination
against 226 in 1906, and 108 in 1905. Of these 70 were found to contain diphtheria bacilli,
and 6 cases returned not suffering.
In 18 cases of diphtheria the source of infection was attributed as follows : —
Previous cases in house or family 15
From friends (visiting) 2
School infection 1
Diphtheria is a disease caused by a characteristic bacillus known as the Klebs Loeffler
Bacillus which occurs in the throats of persons attacked by the disease. It seems to be
conveyed from person to person by direct contact, and there is no virulent disease which will
spread more rapidly under certain circumstances than this will among school children. It is
more or less directly conveyed from throat to throat by children passing sweets, slate pencils,
and other articles which they are liable to put in their mouths, from one child to another.
Kissing an affected person on the mouth will also frequently give rise to the disease, and an
infected child coughing in the neighbourhood of non-infected ones will also often transmit the
disease to them. Sometimes the bacilli will exist in the throat for a long time without producing
any symptoms, but such children while not suffering themselves will be liable to convey the
infection to others.
For this reason they have been called " Carrier " cases, and as expressed in previous
reports my belief is that a large part of the spread of the disease is due to such cases. Since
1902 an endeavour has been made in this Borough to prevent any of these " Carrier " cases
returning to school, and each Annual report has contained some account of the working of the
plan. This consists in getting the parents of a child which is notified as suffering from
diphtheria to bring up the other members of the family within a week or so after the removal or
recovery of (he case to the municipal laboratory at the Town Hall for examination. If
diphtheria bacilli are found in the throats they are excluded from school for a fortnight, and if
then found to be free, are allowed to return to school. The number of children thus examined
in 1907 was 437, belonging to 186 families. Out of this number 51 had diphtheria bacilli in
their throats or noses, and of these 17 subsequently developed the clinical symptoms of
diphtheria and were notified as such.
One case which was returned from hospital as not suffering from this disease deserves
special mention, and the following report was made to the Public Health Committee on 12th
November : —
On Monday, the 21st ult., I received a notification from Guy's Hospital that Joseph
Baker, aged 31, of 48, Bermondsey Wall, was suffering from diphtheria. Upon enquiry
it was found that he attended the hospital late Saturday, 19th ult., and was found to be
suffering from a rather severe diphtheritic throat. A swab was not taken for bacteriological
examination; but since the symptoms warranted his immediate removal, an ambulance
was sent for, and he was sent to the Park Hospital about 9 p.m. He seems to have been
detained there long enough to be examined, and was then returned home as not suffering
from diphtheria, arriving at his home about 12.30 a.m. On Tuesday, the 22nd, there was
some difficulty in getting hold of the man for me to examine, since he considered he had no