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brought to light 12 positive carriers of the disease in
one school. Further swabbing of home contacts and
pupils at two other schools produced a total of 67 persons
who were harbouring the organism by the end of the year -
56 children, 4 pre-school children and 7 adults.
The majority of these cases were treated in hospital
to render them free from infection and to prevent them
from being a danger to others, particularly unimmunised
children.
There was a sharp fall in the number of "carriers"
discovered in the early weeks of 1960. Intensive work
by local general practitioners and the public health
staffs of both the Borough Council and the L.C.C. was
carried out to discover cases in the community and to
provide immunisation for many children who had not been
so protected. By the end of January 1960 some 76
positive cases were known, including 17 patients who had
been re-infected on return home from hospital. Up to
that time 236 swabs had been taken for bacteriological
examination.
There were very few clinical cases of diphtheria in
this outbreak, and those only mild in character, probably
due to the resistance acquired by the community by
immunisation in the past, but this occurrence has
emphasised the importance of maintaining a high level of
immunity in the child population against this dangerous
disease. It serves as a dramatic reminder, also, of the
damage that can follow unbelief in the efficacy of
immunisation - the unnecessary occupation of hospital
beds, the needless taking up of the time of health workers,
the avoidable absence from school, and the risks to health
and life. These are some of the things that one or two
people, lacking a communal health consciousness, can
bring about.
Compulsory removal of tuberculous patients.
Section 172 of the Public Health Act, 1936, empowers
a local authority to secure the compulsory removal to
hospital of a tuberculous patient who is in an infectious
state, but this Act does not apply to London, and the
Public Health (London) Act, 1936, does not contain any
similar provisions. It was therefore, not possible to
take any action in a case brought to the notice of the