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37
Diphtheria.
The total number of patients certified to be suffering from Diphtheria
was 412 as compared with a total of 582 for the previous year. Of
this number 24 were errors of diagnosis, and 30 were cases amongst
the Staff of the South-Eastern Hospital.
There were 14 deaths as compared with 19, 23 and 15 for the three
preceding years, giving a death rate of 0.12 per 1,000 population as
compared with 0.07 for England and Walgs, and 0.09 for London.
Year 1921 - 363 notifications; 13 deaths
„ 1922 - 459 „ 39 „
„ 1923 - 417 „ 33 „
,, 1924 - 374 „ 15 „
„ 1925 - 610 „ 23 „
„ 1926 - 582 „ 19 „
„ 1927 - 412 „ 14 „
In my report last year a full statement was made on this subject.
The causes, the prevention, the question of immunity, the Schick test,
Inoculation, etc., etc., were dealt with at length. It is not necessary
to recapitulate.
The table given herewith speaks eloquently of the work done as
regards testing and inoculation. This work has been carried on without
incident, without any disturbing event, and has been gratefully received
by the parents. All parents were circulated through the schools.
Some 650 children attended during the first year and although many
thousands might have been brought, still this was, in a relative sense,
a good beginning. Nevertheless, many of those inoculated were
contacts of actual cases; many parents are willing to have their children
inoculated if a case occurs in the family. A child comes home from
hospital after diphtheria and, though cured of the disease, the germ is
frequently stored in the tonsils or in the tissues at the back of the nose.
Some time after, the germ passes out of the tonsil, etc., and is conveyed
to another member of the family with the result that another case of
diphtheria occurs. How often have I seen this happen ! If diphtheria
occurs in a family it is madness not to have the other children inoculated;
this is the only possible way in which they can be protected against the
disease.
During the year 1927 the contacts of all cases of diphtheria were
examined by me. Further, children coming from hospital after
diphtheria were likewise examined. Schick test and Inoculation have