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34 [Appendix IV.
In accordance with an arrangement arrived at some years ago, duplicate school notices are
exchanged with the adjacent districts. Last year 67 such notices were received from outside,
5 relating to children attending Board schools, and 62 other schools. The numbers of certificates
from each of the districts during the last two years were:—
Scarlet Fever. Diphtheria.
1899. 1900. 1899. 1900.
Willesden 25 23 35 17
Chelsea (Kensal Town) 4 1 4 1
Kensington 7 9 3 12
Marylebone 2 3 — 1
It is not possible to distinguish between scholars attacked and scholars excluded in these returns,
neither has any account been taken of the certificates received in connection with cases of enteric
fever.
BACTERIOLOGICAL DIAGNOSIS.
There was a steady increase in the use of this valuable aid to diagnosis during the past year.
In all, 68 specimens were submitted for examination, viz., 36 from suspected cases of diphtheria,
25 of enteric fever, 6 from patients just returned from hospital who gave rise to return cases, and
1 from a suspected case of plague. The results obtained from the specimens of the two first groups
were:—
Diphtheria. Enteric Fever.
Suspicion confirmed 16 13
,, negatived 18 12
Result doubtful 2 —
It is probable that, had this aid not been available, the cases which gave the negative (and
doubtful) results would have been recorded as the disease suspected. It is needless to dwell upon
the gain resulting from the use of the tests in the direction of anxiety allayed, loss of business,
expenditure for disinfection, &c., &c. It should be added that in each case the results were
communicated to the medical attendant only.
It would be eminently desirable if the tests were employed in every suspected case and
certification delayed until the results were known. Of course there are instances in which it would
be unsafe to delay the isolation of a suspect at home, and such cases must be certified and removed
forthwith. Such cases, however, form but a comparatively small proportion of the cases notified.
It would further be desirable that, where patients are treated at home, isolation should be kept up
until the throats have been found free from the bacilli of diphtheria.
No work has been undertaken up to the present in connection with the diagnosis of
tuberculosis, except that 39 samples of milk were bacteriologically examined during the first quarter
of the year. This matter will be dealt with later on in speaking of the mortality from the disease.