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29
School attendance is either alleged by the parents or surmised
by myself, on good grounds, to be the cause of 14 attacks during the
year, and to be responsible for 11.6 per cent. of the cases as against
9.7 per cent. in the preceding year.
Four cases of the infection were imported into the Parish. In
one case it was very clear that a preceding tonsilitis of several weeks
duration predisposed to an attack of Diphtheria. In two cases the
attack was preceded by "sore-throat" in other members of the
family; and in three cases the infection was contracted by visiting
infected homes. One case was contracted in Hospital. Where two
or more cases occurred in one house the later cases almost invariably
took the infection at the same time as the patient first affected.
In many of the cases I was unable to trace the origin of the
disease in any satisfactory manner; that is to say after carefully
ascertaining all the facts, the origin of the infection could only be
conjectured, and it was impossible to do more.
In this disease the spread of the infection (and by consequence
the mortality) are largely due to the unfortunate circumstance
that the early diagnosis of the disease from clinical symptoms is
frequently difficult and impossible, and Bacteriology alone can solve
the difficulty in many cases. The Diagnosis outfits provided by the
Vestry during the year to the medical practitioners in Stoke
Newington have been appreciated. Every practitioner has been kept
supplied with such an outfit, and has thus had at his disposal the
means of procuring a bacteriological diagnosis of both Diphtheria and
Typhoid Fever. The following is a list of the applications received,
together with the results of a careful examination performed for the
most part at University College, London.