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22
It is to be borne in mind that diphtheria is an infectious disease, due to a
micro-organism; and where conditions exist which favour the growth and dissemination
of the micro-organism there the disease is likely to prevail. Infection is not
conveyed to any great distance by the air, free aeration as a rule renders it inert; but
close contact with infected persons or things, especially in overcrowded and illventilated
rooms, favours the spread of infection. Where children are gathered
together, as in churches, chapels, Sunday schools, and places of entertainment,
conditions may prevail which favour the spread of infection. With respect to the
influence of the public elementary schools in favouring the prevalence of diphtheria
in the Metropolis—a matter which has been engaging the attention of Health Officers
for some few years past —when it is taken into consideration that diphtheria is an
infectious disease, capable of being transmitted from person to person, and, I believe,
this is the common way in which the disorder is spread; that age is an important
factor, children under 15 years of age being by far the most frequent sufferers; and
that unrecognised cases of diphtheria exist, perhaps to a greater extent than is
generally supposed; it is highly probable that they are not unfrequently the medium
by which the disease is spread from one family to another. When diphtheria is
prevalent, all cases of "sore throat" should receive attention, and under no circumstances
should children suffering from "sore throat" be allowed to attend school.
The milk supply is sometimes the means of distributing the infection of
diphtheria; but no cases occurred during the year in this parish where there was any
suspicion attached to the milk. Animals, especially cats, are sometimes credited
with introducing the infection of diphtheria into a household. In three or four
instances which came under my notice, there was suspicion attached to the domestic
cat, but the evidence was not conclusive.
DIARRHŒA.
There were 151 deaths from this cause, 139 which were of children under 5 years
of age. Of Infants under twelve months old there were 110 deaths. Of persons aged
55 years and upwards there were 10 deaths.
The mortality from diarrhœa in Shoreditch varies considerably from year to year
as the subjoined figures shew.