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November, 1928; he was removed to hospital oil the 1st of that month and discharged to
his home on the 22nd December of the same year. On the 31st December,, the two "return"
cases (R.G. ana A.G.) occurred, B.G., the primary patient, was re-notified by the Medical
Officer of Health and again removed to hospital. The diagnosis on removal was not varied
on any of the four occasions.
In London, 11,788 cases were notified giving rise to 337 deaths.
We endeavour to co-operate with the Medical Superintendents of the Fever
Hospitals serving the County of London; 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 26 notifications of diphtheria were received from two hospitals
in the Borough. Of these 26, 11 were reported as "nasal" cases and three as
harbouring diphtheria bacilli. Twenty-three of the notifications related to
in-patients. The remaining three were nurses on the staffs of hospitals; all these
three were clinical diphtheria.
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 are attacked and subsequently the disease spreads from
them to the children.
The possible objection that such people 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
—those going East were protected against smallpox, typhoid and the paratyphoid
fevers, cholera, dysentery and plague. Who can show that they suffered any
harm by taking advantage of the progress of science?
The Schick test and immunisation against diphtheria is already being
successfully applied to the nursing and domestic staffs in certain hospitals, including
those of the Metropolitan Asylums Board. Moreover it is becoming more and
more the rule for nurses on the staffs of infectious diseases hospitals to be
immunised against the diseases they might contract as the result of their being
in contact with infectious patients.
We are able to report that diphtheria immunisation has been or is being carried
out at several hospitals in the Borough.
Diphtheria Contacts.
As in former years wo have continued to swab all diphtheria contacts among
school children and toddlers,
E