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was 728, but 19 were subsequently sent home as not suffering from
diphtheria. The return cases numbered 6. (A return case is
defined as one which occurs within 28 days after the release of
the original case from isolation.) To avoid the possibility of return
eases occurring, the women Inspectors visited the homes of the
patients who were discharged from the hospitals and strongly
advised that the patient should have a separate bedroom for a
few days. The attendant was also urged that should any discharge of the nose or ears occur, a doctor's advice and treatment
should be immediately obtained. The deaths numbered 23. The
following table shows the number of notifications and deaths
from this disease during the past 7 years:—
Year.
Number of
Notifications.
Number of
Deaths.
1921 875 64
1922 821 63
1923 875 72
1924 831 42
1925 934 40
1926 1,063 54
1927 768 23
Diphtheria Carriers.
It is a well-known fact that certain individuals harbour
diphtheria bacilli in their nose and throat without themselves
being ill, but are capable of conveying infection to others by
coughing and sneezing. Such persons are known as carriers. The
routine swabbing of contacts for the discovery of carrier cases is
carried out whenever the spread of this disease in a family is
suspected to be due to this cause. A carrier of virulent germs
presents a very difficult problem, inasmuch as he is likely to
remain a carrier for an indefinite period in spite of isolation and
treatment. Under a universal scheme of immunisation he could
be ignored, since he would obviously be innocuous to an immuned
population, and, in fact, would probably be a blessing in disguise,
as he would, by distributing small doses of infection, help to
maintain the immunity to the highest point of efficiency.
Diphtheria Prevention.
It is the duty of the Medical Officer of Health to create, by
suitable publicity, a demand for prophylactic measures to prevent
diphtheria.
The family practitioner has also a definite moral and professional
responsibility in the matter of educating his patients in
the proved methods for the prevention of this disease.
Propaganda along these co-operative lines will stimulate
public interest in the question of artificial immunity to diphtheria,