London's Pulse: Medical Officer of Health reports 1848-1972

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Holborn 1923

Annual report of the Medical Officer of Health, for the year 1923

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Diphtheria.

Ninety-eight notifications of diphtheria relating to residents in the Borough were received during the year at the following ages:—

Under 1 year4
1 to 5 years26
5 ,, 15 „22
15 „ 25 „31 (includes 14 hospital nurses)
25 „ 45 „12
45 „ 65 „3

Of these 97 were removed to hospital. Eight cases were returned from the
hospitals of the Metropolitan Asylums Board certified as not suffering from diphtheria.
Two of these were apparently "carriers," as diphtheria bacilli were found in the swabs
taken before removal of the patients. Five deaths occurred.
Ten ''secondary" cases were notified, but as one of these was found not to be
diphtheria the number of genuine "secondary" cases was only nine. A "secondary"
case is one occurring in the same household as the primary case.
The 10 secondary cases are exclusive of 14 cases of diphtheria occurring
amongst nurses in two hospitals in the Borough (10 and 4 respectively). From the
same hospitals 48 in-patients (25 and 23 respectively) were notified as suffering
from diphtheria; none of the in-patients were residents of the Borough.
There were two ''return'' cases notified eleven days after the return of
one original case, swabs were taken from the throat and nose of the original case
on her return home from hospital, but she was not found to be harbouring
diphtheria bacilli.
In London 10,353 cases were notified giving rise to 602 deaths.
We endeavour to co-operate with the Medical Superintendents of the
Metropolitan Asylums Board Fever Hospitals; information is now sent to them
as to any bacteriological examinations before admission or after discharge of the
patients, and also with regard to return cases of scarlet fever.
The practice of taking swabs from the throats and noses of child contacts
was continued during the year and 61 children were so swabbed. Of these 37 were
negative and in 24 (39 per cent.) positive results were obtained. In two case where
clinical symptoms also indicated diphtheria the contacts were notified as suffering
from the disease and removed to hospital. Two positive contacts removed from
the Borough after the first swabbing and information respecting these was sent
to the Medical Officer of Health of the district concerned. One contact who was
still positive at the second swabbing was removed to hospital suffering with
scarlet fever. In one case the third swabbing was carried out by the school
medical authorities with negative result.