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They were all cases of " bacteriological " diphtheria. The results
were communicated by telephone immediately to the medical
officer of health of boroughs concerned, and the affected children
and adults were excluded from attendance at the creche. The
facts disclosed do not warrant any cause for serious anxiety. It
has long been recognised that many members of the general public
harbour the diphtheria germ in nose or throat, or both. In various
researches the numbers have been put at percentages ranging from
15 to 30 per cent. In the present enquiry, out of 46 persons examined
9 were diphtheria carriers, equivalent to 19 per cent. None
of the babies were found to be carriers. The carriers were 5 toddlers,
2 probationers, and 2 voluntary workers.
To complete the investigation, virulence tests were made in
respect of the Finsbury residents. These were all returned as nonvirulent.
With reference to the Islington children, 2 virulence tests were
obtained by the Medical Officer of Health for Islington.
One gave a negative result, one a positive result. One child
was taken by his parents to a private medical practitioner, who
considered that there was no need to notify him as a case of
diphtheria, but who promised to take a swab to be tested for
pathogenicity.
The present position, then, is that the recent careful and
thorough investigation revealed that at the creche there are a
certain number of diphtheria carriers among the voluntary helpers,
the staff, and the toddlers, well within the limits of the carrier
percentage of the general population. There has been no recent
outbreak of true clinical diphtheria, diphtheria with membrane
possibly to be followed by paralysis. However, these carriers are
a possible standing menace to the babies and toddlers of the creche,
and it is within the bounds of probability that these diphtheria
bacilli, harboured in the noses and throats of the carriers, often
of a non-virulent type, may occasionally become virulent to their
hosts or others. But it must be confessed that the factors which
determine the lighting up of this virulence are at present unknown.
Now the babies and toddlers, if they are affected with diphtheria,