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The attack-rate per thousand inhabitants was 1·98, against
1·72 in 1914. The case mortality was 8·8 per cent., against 7·9
per cent. in 1914 and 6·5 per cent. in 1913. 10 cases were returned
as not suffering from this disease.
259 specimens were sent in by medical practitioners for
bacteriological examination, against 327 in 1914, and 250 in 1913.
Of these 41 were found to contain diphtheria bacilli, all of which
were notified.
In 1 case of diphtheria the source of infection was attributed
to a previous case in the family.
The following appeared in the report last year and gives an
explanation of the method adopted in this Borough to prevent the
spread of this disease: —
" Diphtheria is a disease caused by a characteristic bacillus
known as the Klebs-Loffler 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