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outbreak occurred at Campsbourne School, and swabs were taken
from the noses and throats of all suspected children in the same
class. One child, who subsequently admitted to have been
ailing, was found to harbour the bacilli of Diphtheria in her
throat. She was sent to the Isolation Hospital, and the outbreak
ceased promptly. Year by year, in preparing my Annual Report,
I have been able to record the occurrence of a school diphtheria
outbreak which was immediately checked by swabbing and by
isolating those who were found to be infective. In some quarters
I believe that the swabbing of contacts is regarded as being
expensive, troublesome and not worth the bother: that, however, is
not my experience. Given a nurse who is able to take the swabs
properly, and a bacteriologist who is competent to examine them,
the control of diphtheria in a school or institution is a matter of
no great difficulty. That, at any rate, has been our fortunate
experience in Hornsey.
Scarlet Fever has shpwn a marked decline in 1922 compared
to the previous year. Altogether 280 cases were notified (Tables
F. and K.). The disease spreads by personal contact, and it isi
the mild and " missed " cases which give rise to others. No
cases were traced to infected milk during the year under review.
Scarlet Fever to-day is a trival complaint, and very different from
that dreadful disease so rightly feared by our parents and grandparents.
Erysipelas was notified on 24 occasions. This disease is no
more infectious or contagious than a poisoned finger or a carbuncle,
and there is no reason whatever why it should be a
notifiable disease. Cases of erysipelas can safely be nursed in
their homes or in ordinary wards of a general hospital, provided
that reasonable cleanliness is observed.
Encephalitis, Malaria and Enteric Fever.—Only one case of
each of these diseases was notified. They call for no special
comment.
Pneumonia.—One hundred and four notifications were received
of this infectious disease. Pneumonia, especially in
children and in old people, is one of the most common causes
of death; and, in order to attempt to reduce the numbers of cases
during the autumn and winter of 1922, a mixed vaccine was sent