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All the cases are investigated by the Sanitary Inspectors, and
the source, if possible, traced. The premises are inspected and if
any sanitary defects exist, a notice is served for their remedy. The
drains are carefully examined, and if necessary tested for defects.
Facilities for Early Diagnosis.— Arrangements can be
made for either the Medical Officer of Health or his assistant to
see, at the request of the private practitioner, suspected or doubtful
cases. Swabs are examined in the laboratory of the Public Health
Department. It is very unwise, however, to rely on the result of a
swab before administering anti-toxin. If a practitioner is so suspicious
as to suspect diphtheria the immediate administration of
anto-toxin should be undertaken. A negative swab does not necessarily
mean that the patient has not diphtheria and a positive swab
that he is suffering from diphtheria. The swab cannot, and should
not, replace diagnosis by clinical signs and symptoms.
Diphtheria Anti-Toxin (Order), 1910.— A supply of antitoxin
is kept at the Health Department and is available for doctors
for the treatment of necessitous Finsbury patients free of charge.
Last year nine vials representing 28,000 units were issued to
the practitioners.
A fee of 5s. od. is also paid to medical men for administering
the anti-toxin between the hours of 9 p.m. and 9 a.m., and 2s. 6d.
at other hours.
The average length of stay in hospital of cases of diphtheria
last year was 65 days.
Cases of diphtheria discharged from hospital as cured are
examined very carefully shortly after their return home, and a record
kept of their condition. If necessary, swabs are taken from the nose
and throat for bacteriological examination. Any cases suspected
of harbouring the diphtheria bacillus in nose or throat are kept
under supervision by the Department and, if necessary, referred for
treatment at one of the special carrier clinics mentioned below.