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41. Mistaken Diagnosis. 32 oases, or 13 per cent of
notifications, were, after removal to hospital, stated to be
not diphtheria. The percentage of the four preceding years
was 16, 15, 8, and 13, respectively.
42. Wilful Exposure. A boy after exposure to infection
in another Borough was found to have congested throat and
Diphtheria bacilli. He was notified and the parents warned.
In spite of this he was repeatedly exposed in the street.
The mother was prosecuted and fined 21/- and 42/- costs.
43. Bacteriological Diagnosis. Since January, 1913, the
Council's bacteriolcgical work has been done by the Bacteriological
Department of the Seamen's Hospital, Greenwich. 608 (958
in 1917; swabs were examined for the presence of Diphtheria
bacilli. In 62 (157 in 1917) the true klebs Loffler bacillus
was found, and 497 were found free from either the Klebs Loffler
bacillus or Hoffman's.
Of the 608 swabs examined, 95 were taken from school
children by the Medical Officer of Health. Of these, 14 contained
the true Klebs Loffler bacillus (so-called positive cases)
and 36 Hoffman's bacillus.
Host of the 14 positive oases had some symptoms, viz.,
enlarged glands, running or sore nose, mild clinical diphtheria
or follicular tonsilitis. These were notified and sent to
Hospital or strictly isolated. Positive cases without any
symptoms were excluded from school and from mixing with other
children outside the house.
Diphtheria anti-toxin is kept at the Town Hall and
the Plumstead and Elthsm Free Libraries, and supplied to medical
practitioners on application at cost price, or free where there
is inability to pay. Last year five quantities were supplied
representing 38,000 units.
ENTERIC FEVER.
44. There were eight cases of Enteric Fever, not including
two cases of mistaken diagnosis notified as Enteric. The caserate
was 0.05, compared with 0.17, 0.05, and 0.05, in the three
preceding years. For the ten years 1892-1901 the rate never
fell below 0.41. The case-rate in London was 0-08.
45. There were two deaths from this disease, giving a
death rate of 0.01. The death rate in London was 0.02.
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