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32
Diphtheria.—336 cases were notified, against 206
in the previous year, there being a sharp rise in the last
three months, the figures for the four quarters being : —
Cases. Deaths.
1st quarter 62 6
2nd „ 70 7
3rd „ 51 4
4th „ 153 15
During the last months of the year there was often
difficulty in securing the prompt removal of cases,
owing to the want of accommodation in the hospitals
of the managers of the Metropolitan Asylums Board,
consequent on several of their hospitals having been
taken over by the War Office. In view of the necessity
for the administration of anti-toxic serum in as early
stage of the disease as possible, the attention of the
doctors practising in Fulham was drawn to the probability
that there would be delay in the removal of
their patients suffering from diphtheria, and the
advisability of giving in all cases an injection of
anti-toxic serum, which could be obtained free of
cost from the Public Health Department at the
Town Hall. As this suggestion was in many instances
not acted upon, a further letter, to the same effect,
was written to them, and the need for the injection
of a dose of at least 8,000-12,000 units in all definite
cases pointed out. After this the practice was
more generally adopted, and 648,000 units of anti-toxic
serum were supplied by the Council for the purpose.
In addition to the notified cases of Diphtheria, a number
of bacteriological, or carrier cases, were found, i.e.,
cases from which the diphtheria bacillus was isolated,
though they showed no clinical symptoms. In view
of the shortage of accommodation even for acute
cases, unless it was suspected that they had infected
others, these carriers were not isolated in hospital,
but were kept at home under observation.
Errors in Diagnosis.—Of the patients notified, 20
or 6 per cent. were subsequently found not to be suffering
from Diphtheria.