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All the swabs proved to be negative except the throat swab
from the patient's father, from which diphtheria mitis, the mildest
form of the diphtheria organism, was grown. Accordingly, he was
admitted to hospital on 19th February so that, as a diphtheria carrier
he would be isolated from the community. In the meantime, both he
and the remaining members of the patient's family had. been given
passive and active immunisation against diphtheria by their general
practitioner; whilst the children in the two classes attended by the
patient and her sister were offered active immunisation, in the majority
of cases in the form of a 'booster' dose.
On 27th February, the medical superintendent of the isolation
hospital reported that no positive throat or nose swabs had been
obtained from the original patient, and as the organism isolated from
her father's throat was without virulence, he considered that the case
could not be confirmed as diphtheria. Nevertheless, there was an
interesting sequal. On the 1st March, the patient's younger sister
was admitted to hospital suffering from a heart condition which frequently
complicates an attack of diphtheria. As a result of this, the medical
superintendent concluded that she had probably suffered from diphtheria
before her elder sister was admitted to hospital as a suspected case.
In due course, the two girls and their father were discharged home.
From time to time during the second half of February, the
medical personnel of the public health department were asked to see
cases where the possibility of diphtheria had been mooted. Fortunately,
in each case the diagnosis could be refuted on clinical grounds; but
the episode emphasised the fact that few doctors under the age of 45
years have seen a case of diphtheria in this country. Furthermore,
both these incidents, in Hornsey and Tottenham, served to stress how
necessary it is to maintain a high level of immunity against this
disease in the population, if diphtheria is not again to become epidemic;
and, at all clinics in the Area, the immunisation of infants was
actively pressed.
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