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76
Report of the Medical Officer of Health.
'Spot' map, however, shows that this part of the estate has not
enjoyed a greater freedom from the disease than the remainder.
The only cause which can be found is the one mentioned by the
Medical Officer of Health in his report on the matter."
Of the 69 cases notified only three were fatal, one male and
two females, of three and five years of age respectively.
This gives a case mortality of 4.3 per cent. only, compared
with a case mortality of 9.3 in the whole Borough.
Unrecognised cases in this outbreak were responsible for a
large proportion of the cases. In the house where eight cases
occurred one unrecognised case infected the others, and it was
only by a bacteriological examination after a second case occurred
that the original case was detected. In several of the cases the
diagnosis was made only after bacteriological examination.
In any further outbreaks it will be advisable to have the
throats of all children in school examined and swabs taken for
bacteriological examination, but this is a step which could only be
taken if the outbreak was serious and the sanction and approval
of the School Board obtained.
The following Table shows the number of cases of Diphtheria
and their relationship to the respective schools.
In the Borough as a whole, of 750 cases of Diphtheria and
Membranous Croup, 342, or 45.6 per cent., did not attend any
school, either above or below the school age, leaving 408, or 54.4
per cent., cases of children at school.
In Table III. of the Local Government Board's Tables it will
be seen that 375 of the cases occurred at ages five to 15, the theoretical
school ages. A large number of children, however, attend
school who are under five years of age. Whether this is a desirable
thing either from an educational or sanitary point of view is a
matter of opinion, although recent educational statistics show that
at least from an educational point of view nothing is gained by the
attendance of children under five years of age.