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59
Of the 44 cases of diphtheria:—
1 was under 1 year.
13 were 1 to 5 years.
15 „ 5 „ 15 „
12 „ 15 „ 25 „
1 was 25 „ 45 „
2 were, 45 „ 65 „
One death occurred.
Thirteen "secondary" cases were notified. A "secondary" case is one
occurring in the same household as the primary case.
Eleven of the 13 "secondary" cases were nurses at hospitals in the
Borough; from the same hospitals 50 in-patients were notified as suffering from
diphtheria, none of these was resident in the Borough. Two of these were notified
as carriers only, and eight as " nasal " diphtheria.
One "return" case was notified 11 days after the return home of the primary
case from hospital. Six days after the return home of the primary case the mother
of the primary patient, with a baby aged three months, was admitted to a hospital
suffering with tonsilitis. Five days afterwards the baby was notified as suffering
with diphtheria and was removed to a hospital of the Metropolitan Asylums Board.
The mother and baby both died, the cause of death in the case of the mother being
given as "septic tonsilitis and septic pneumonia," and of the baby as
"diphtheria."
In London 12,183 cases were notified giving rise to 387 deaths.
We endeavour to co-operate with the Medical Superintendents of the
Metropolitan Asylums Board Fever Hospitals; information is now sent to them
as to any bacteriological examinations before admission or after discharge of the
patients, and also with regard to return cases of diphtheria or scarlet fever.
Diphtheria in Hospitals.
During the year notifications were received from two hospitals in the Borough
of 61 cases of diphtheria. Of the 61 cases, six were reported as "nasal" cases and
three as harbouring diphtheria bacilli. Fifty of the cases were in-patients, all
being non-residents of Holborn. The remaining 11 were nurses on the staffs of the
hospitals; of these ten were clinical diphtheria, and one harboured diphtheria
bacilli.
The number of cases of diphtheria occurring from year to year amongst the
nursing staff of hospitals suggests the need for the immunisation of hospital
nurses. It would seem to be obvious that fever hospital nurses should be
protected against diphtheria and it is difficult to avoid the conclusion that all
hospital nurses, nursing in children's wards, should be immunised. It must be
within the experience of many that nurses in children's hospitals and subsequently
the children themselves are often attacked.
The possible objection that a nurse would have to be immunised against
diphtheria, scarlet fever and typhoid and paratyphoid fevers does not carry much
weight. Many during the war were immunised against more diseases than these