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Cases of mistaken diagnosis are not excluded from the above Table.
Home visiting, disinfection and school exclusion are carried out on the lines indicated in
the paragraphs dealing with scarlet fever.
The number of Kensington deaths was 14, representing a case of mortality of 6.9 per cent.
In the three preceding years the deaths were 24, 25 and 34.
Two patients developed diphtheria within 28 days of a member of their family having returned
from a fever hospital after having been treated for diphtheria.
On investigation it was found that one of the "primary" or returning cases had nasal
discharge on leaving the hospital, and it is possible that in this case the nasal discharge was
responsible for the spread of infection. There is no evidence to show how infection was conveyed
in the other case.
Twenty-six notified cases admitted to hospital were found not to be suffering from diphtheria
or any other infectious disease.
Owing to the degree of accuracy which has now been secured by bacteriologists in the
diagnosis of diphtheria, it is customary to take a throat swab for bacteriological examination in all
suspicious cases, and for some years past the Council have paid for such examinations performed
at the Lister Institute on behalf of Kensington patients.
Sterile swabs are obtained from the Town Hall, and, in order to reduce the interval which
occurs from the time the doctor takes the swab to the time he obtains the result, arrangements
have been made for medical men to leave inoculated swabs at the North Kensington Tuberculosis
Dispensary, 119, Ladbroke Grove, before 3.30 p.m., or at the Town Hall, before 4 p.m., on any day
(Saturdays, Sundays and Bank Holidays excepted). Swabs so left are collected by one of the
Council's messengers, who delivers them at the Lister Institute before 5 p.m. on the same day, and
the results are telephoned to the doctors on the following morning. On Saturdays, Sundays and
Bank Holidays medical men can send swabs direct to the Lister Institute before 5 p.m. and obtain
an equally speedy result.
During the year 559 throat swabs were examined at the Lister Institute at the expense of the
Council, and of these 79 gave a positive diphtheria result.
It is well recognised by the medical profession that the early administration of anti-toxin not
only reduces the mortality from diphtheria, but causes the disease to run a milder and shorter
course; further, by lessening the duration of the patient's infectivity to others, it reduces the period
of occupation of a bed in an isolation hospital.
Under the Anti-toxin Order, 1910, Local Authorities are empowered to supply diphtheria
anti-toxin for administration to patients who are too poor to pay, and on signing the necessary
declaration that the patient cannot afford specific treatment, a medical man can obtain a free
supply from Mr. Worsley, Chemist, at No. 135, Ladbroke Grove, W. 10, or from the Public Health
Department at the Town Hall. The anti-toxin is obtainable at all hours of the day and night
from Mr. Worsley's premises, and during office hours from the Town Hall. When the Town Hall
is closed, applications for anti-toxin can be made to Mr. Sutton, an Officer of the Department,
who lives at No. 1, Hornton Place, Hornton Street, (only a few yards from the Town Hall).
The Council loan syringes with portable sterilizers to doctors for the purpose of administering
the anti-toxin. Medical men administering the Council's anti-toxin to poor persons are, on
application to the Medical Officer of Health, paid a fee of 5s. per patient treated.
In 1923, the Borough Council supplied 178,500 units of anti-toxin for 52 patients at a cost of
£13 8s. 10d. No fees were claimed by medical practitioners in respect of the administration of
anti-toxin during the year.