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96
have within a few hours submitted swabs to various laboratories with
negative results.0
"The necessity of a gradual education of the public, and also the
profession, to the importance of this step forward will justify its application
being gradual and only to schools where diphtheria is actually
prevalent and threatening."
London County Council.
Education Offices,
Victoria Embankment, W.C.
190 .
School.
Dear Sir (or Madam),
While Diphtheria is present in the district I shall be glad if you
will exclude any child suffering from sore throat, and forward the name
and address to the Medical Officer (Education), the Medical Officer of
Health for the District, and the Divisional Superintendent.
The child should not be allowed to resume attendance until a certificate
(based upon bacteriological examination) has been furnished, stating
that it is free from infection. This precaution is necessary to prevent the
spread of the disease. If necessary this certificate can be obtained from
the local Medical Officer of Health.
This rule will apply until further instructions are sent you.
Yours faithfully,
JAMES KERR, M.D.,
Medical Officer (Education).
* The Lister Institute of Preventive Medicine,
Chelsea Gardens, Chelsea Bridge Road,
London, S.W.
September 28th, 1906.
Dear Sir,—In reference to your letter of 25th September re diagnosis of a fatal case
of Diphtheria. It is not uncommon to fail to find diphtheria bacilli in swabs taken
from the throats of undoubted clinical cases of diphtheria. In an enquiry made into
this point by Caiger & Pakes (British Medical Journal, 1901. Vol. II., p. 758), such a
failure occurred in no less than 25 of 78 cases. Of the swabs received here not more
than 20 per cent. give positive results.
I imagine that this failure is not infrequently due to the swab not being taken