View report page

41
nose contained diphtheria organisms, and the child was taken into
hospital there.
As diphtheria is spread, almost, if not entirely, by contact of one
person with another, the systematic examination of children at schools
and of persons who have been in contact with cases ought to check its
spread very materially.
In this way the co-operation of Dr. Kerr, the Medical Officer of the
Education Committee, has been very helpful with regard to scholars.
He finds that when a school becomes a source of infection, it is
generally among children between the ages of 5 and 8. Such children
seem to have the power of partial resistance to the onslaught of
diphtheria bacilli, and thus have a mild attack which does not prevent
them continuing attendance at School. They are thus more dangerous
to the community than serious cases, the nurture of which is early
recognised.
Typhoid Fever.—Forty-one notifications were received, but four of
the persons were afterwards stated to be suffering from some other
disease. As may be seen from the table on p. 38, this number is lower
than has occurred in any previous year, and I have to point out, as I
have done on previous occasions, that in the majority of cases the
infection has not been contracted in Westminster. No history of any
kind was discoverable in eight cases; in twenty-one instances the
persons came home or to stay in the City from abroad or from other
parts of England; of the remaining eight cases, one was infected while
nursing a typhoid patient in hospital, and seven may have contracted
infection through articles of food. The marked decrease in the number
of cases during the last few years may be taken as evidence of the
greater care which is being taken to prevent the consumption of
sewage-polluted food.
Bacteriological examination of the blood was made in twenty-two
instances, in ten the result was negative, in twelve positive; but in two
of these the cases were afterwards decided to be appendicitis and some
other form of intestinal affection, both of which were possibly due to
some organism derived from sewage. In one case cockles had been
eaten shortly before the appearance of the symptoms.
The distribution of the cases according to wards are shown in
Table XII. There were five deaths.
Puerperal Fever.—Twelve notifications were received, seven
emanating from Victoria Ward. The average number of cases hitherto
has been five. In addition, there was a fatal case from Eegent Ward,
not discovered until after death; five of the other cases were fatal.
The cases were distributed evenly throughout the year. The women in
each case were attended by different doctors, midwives and nurses.