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18
ON THE SANITARY CONDITION OF
of those who contend that school attendance does not play an important
part in the spread of this complaint because the teachers
have not been able to detect any definite case of diphtheria.
More supervision is necessary in regard to these matters in schools
and if this disease is to be prevented from finding a permanent
home in London, as it has done in many cities on the Continent,
it is necessary that no person in an affected house should be
allowed to mix with those outside it until their throats can be
shown to be free from the specific bacillus; that on the occurrence
of a case in connection with any school examination, the Medical
Officer should have power to examine the children in the school:
that a supply of diphtheria antitoxin should be available for
protecting* persons who have been exposed to infection.
I have had some correspondence during the past year with
the Metropolitan Asylums Board with regard to cases which have
been suspected of being still in an infectious state when sent
home from hospital, or of carrying infection with them, and with
the view of making prompt enquiry into such cases, that Board
has appointed a gentleman to conduct investigations on their
behalf during the six months commencing on the 1st October last.
In the only case which has occurred since then I was not advised
of the return home of the patient until such a period had elapsed
as prevented definite results being obtained. It is extremely
desirable that the Sanitary Authority should be notified by the
Asylums Board when patients are about to be discharged.
The Asylums Board have arranged for the distribution of
antitoxin through medical officers of health in the event of their
being unable to find accommodation in their hospitals for any
case.
Mr. Cribb, the bacteriologist appointed by your Board, reports
that during the year 1898 he has examined 168 specimens taken
from the throats of persons suspected of suffering from diphtheria,
or desirous of knowing that they were free from infection aftt r
* Experience has shewn that an injection of about half the ordinary dose of
antitoxin, will protect a person from diphtheria for a period of 3 or 4 weeks at
the least, probably in many instances for a longer period. The protection given
is believed to be equal to that conferred by an attack of diphtheria.