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The present epidemic of Diphtheria commenced with a single ease on the 17th
August. On the 25th August, two further cases occurred, and so at intervals
of one or two days cases continued to occur until the 8th September ; then there
were intervals of six days, four days, two days, and one day, and the last three
cases occurred on the 21st September. The total number of cases was 54, of
which only 4 were girls, all the rest being boys, the disease evidently spreading
by personal infection from certain boys in ward 1, thence to wards 2, 3, and 4.
the cases being more numerous in the two former wards, and less numerous in
the two latter wards, towards the end of the epidemic. Of the 54 cases, in no
less than 38, the diphtheria bacillus was found but there were no patches in
the throat; in 10 cases the diphtheria bacillus was found in conjunction with
patches in the throat; and in 6 eases there were patches of membrane in the
throat, but no bacteriological examination was made before removal of the
patient to hospital. There seems little doubt that the prompt removal of
diphtheria bacilli carriers to the Asylums Hoard Hospital, and disinfection
carried out by the Foundling Hospital Authorities after each case, put an end
to the epidemic. In addition to the resident officers and the household
servants, there are about 350 inmates in the institution, of whom about one
half are boys and one half girls.
In the course of examining the drainage, it was found that certain openings
into the drain for surface water had been enclosed, or built in, or surrounded by
building, and the architect and surveyor to the estate was advised that these
openings should be placed outside the building, and the surface drainage has
been diverted for this purpose. In any case, the specific diphtheria bacillus is
not conveyed by sewer gas or drain air. There is no reason to think that the
condition of the drainage was the cause of the outbreak, since the weather of
August was cold, wet, and gloomy enough to lower the vitality of the children
and to produce relaxed throats.
LONDON COUNTY COUNCIL.
Extract from Rules and Regulations in regard to Infectious Diseases
affecting children attending the Council's Public Elementary, Day
Special, and Day Industrial Schools. Adopted 12th July, 1910, and
7th May, 1912.
Diphtheria.
Rules for Guidance
Immediately diphtheria appears in a school great attention should be directed
to all children who are suffering from sore throat or sore nose, especially those
in the same class in which the patient sat, and those who are likely to have
been in any way associated with the patient. Special instructions to exclude
all children suffering from these symptoms will be sent to the school by the
school medical officer when diphtheria threatens in any class, together with a
supply of cards (M.O. 35) to be distributed to the children so excluded. Children
examined by the school doctor and found to be harbouring diphtheria bacilli
will also be excluded. Any child excluded under any of the above circumstances
must not be allowed to return to school within four weeks unless a medical
certificate has been produced to the effect that a culture has been taken and that
no diphtheria bacilli have been found. Forms M.O. 95 are supplied for this