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62
Diphtheria.
Notifications relating to 57 cases of diphtheria occurring in residents in the
Borough were received. All were removed to hospital. Eleven were found not
to be suffering from diphtheria, and two cases notified from hospital staffs were
notified as "carriers" only.
Of the 57 cases of diphtheria:—
1 was under 1 year.
12 were 1 to 5 years.
19 „ 5 „ 15 „
15 „ 15 „ 25 „
9 ,, 25 ,, 45 „
1 was 45 „ 65 „
Two deaths occurred.
Twelve "secondary" cases were notified. A "secondary" case is one
occurring in the same household as the primary case.
Eight of the 12 "secondary" cases were nurses or maids at hospitals in the
Borough; from the same hospitals 25 in-patients were notified as suffering from
diphtheria, none of these was resident in the Borough. Seven of these were
notified as carriers only.
Two "return" cases in the same family were notified 9 days after the return
home of the primary case from hospital.
A second attack of diphtheria in a child, aged 12, the previous one being six
years before, occurred during the year.
In London 12,241 cases were notified giving rise to 388 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 37 cases of diphtheria. Of the 37 cases, six were reported as " nasal " cases and
seven as harbouring diphtheria bacilli. Twenty-five of the cases were in-patients.
The remaining 12 were nurses (8) or maids (4) on the staffs of the hospitals; of these
10 were clinical diphtheria, and two harboured diphtheria bacilli.
The number of cases of diphtheria occurring from year to year amongst the
staff of hospitals suggests the need for their immunisation. It would seem to be
obvious that fever hospital nurses and ward maids should be protected against
diphtheria and it is difficult to avoid the conclusion that all assisting 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 such people would have to be immunised against
diphtheria, scarlet fever and typhoid and paratyphoid fevers does not carry much