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62
Diphtheria
A small outbreak of 48 cases occurred during the last quarter of
1958. Of these 30 were notified in the Borough of Finsbury. The
outbreak occurred in 2 phases 30th September-24th October, and 10th
November-3rd December 1958, and children at three schools were
affected.
The first cases, 2 mothers, were confirmed on September 30th, and
energetic measures were taken at once to confine the spread of the
disease. The infectious disease visitor immediately visited the homes
of the children to ascertain:-
1. The school attended, if any.
2. The history of the illness.
3. All close contacts and to exclude them from school pending
bacteriological reports.
4. The immunization history of each child.
The Divisional Medical Officer of London County Council, Health
Division Three was consulted and it was agreed that he should be
responsible for the swabbing of children in school, and that the
Borough Medical Officer should be responsible for all children absent
from school, and for the swabbing of all contacts in the houses of any
children proving to be carriers as a result of school swabbing.
Bacteriological examination showed that the causative organism
was a virulent strain of Coryne bacterium diptheriae.
On October 5th a fresh case occurred, unconnected with the previous
ones. Again all close contacts and class contacts were swabbed, and
all carriers were removed to hospital. Child contacts with negative
swabs, who had never been immunized were given simultaneous active and
passive immunization.
The second phase began with the discovery of a fresh case on
November 10th 1958, and the routine measures were again undertaken. No
direct connection has been found between the cases occurring in the
first and second phases.
In all these were 30 cases with positive nose or throat swabs.
One girl 6 years old was ill, probably with a clinical attack of
true diphtheria. She had never been immunized.
Twelve children were mildly ill. It is not certain whether these
were cases of diphtheria or carriers, ill from some other cause. Of
these six had been fully immunized and two more partially immunized.