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DIPHTHERIA
Two cases of Diphtheria were notified and confirmed during the year
(see report below), the only cases since 1949, when cue case was confirmed.
Only one death has occurred during the past sixteen years.
Immunisation, has played a major part towards the present excellent
position, nevertheless it is constantly necessary to publicise the efficacy
of such a service. Details of services provided during the year will be
found an page 18.
4 local practitioner, visiting an adult woman patient, suspected
clinical diphtheria. Her son, aged 5, had a heavy nasal discharge also
considered to be diphtheritic; swabs taken confirmed the diagnosis, and
both were admitted to a fever hospital. While in hospital the mother
showed evideuce of a circulatory disturbance which suggested that the germ
was capable of producing the heart trouble characteristic of diphtheria in
susceptible subjects.
The child bad been a pupil in a local infants' school, and as a
precaution the teacher and all (32) children present in his class were
swabbed. Fire children were found to be carrying the same germ, and
swabbing of 8 children who were absent from school produced another 5
positives. Enqiry at the school showed that most of the children had
been immunised, tat one of the children, unprotested and positive and who
was absent from school, was removed to hospital. The family contacts of
all positives were swabbed, disclosing two further positives - one a child
attending another class of the same school, and the other a pupil the
junior section of the same school which was housed in a different building
some distance away. The husband of the first case was also found to be a
carrier, and was admitted to hospital.
Pending mors detailed bacteriological investigation of the germ, it was
decided to warn Medical Officers of Health of adjoining Boroughs. All local
general practitioners were apprised of the situation and given indications as
to treatment, isolation and quarantine. The parents of the children excluded
from school by reason of positive swabs were urged to seek medical attention
and all parents of children attending the school were informed of the
situation. The master was also brought to the notice of the Ministry of
Health.
By this tints the school had broken up for the Christmas holidays.
Further bacteriology by three laboratories on this organism showed it to be
an atypical diphtheria germ which was not virulent for guinea pigs. This was
confirmed by Professor Robinson of the Liverpool Diphtheria Reference
Laboratory, and the germ was labelled "Orchard Street" for local reference by
Dr. Tomlinson of the Public Health Laboratory Service. (Loadon).
In view of the apparent avirulense of the organism and the absence of
notable symptoms or complications among the children affected, and having
regard to the pressure an the Public Health Laboratory owing to the concurrent
outbreak of dysentery in a nearby large institution, it was decided to await
the re-opening of the school before undertaking further swabbing.