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46
ococcus in the throat, and in these cases the result was negative. It is
evident that no conclusions on this head can be drawn from these data.
Not much light, indeed, is thrown by our experience in St. Pancras upon
the question of carriers. Only 22 contacts were swabbed (in contact with 8
cases), of whom 3 exhibited the meningococcus (in contact with 3 cases), and
the rest were negative.
Some interesting facts, however, in regard to infection from the Military,
appear when the cases are analysed from the point of view of the virulence of
the infection as indicated (1) by the occurrence of further cases in the same
family, and (2) the fatality of the illness. In regard to (1), it was observed
that tbe only cases which were followed by secondary cases in the same
family—or, indeed, in the same house—were the two cases in the persons of
soldiers. Both of these secondary cases were fatal (for details see below).
Further, in regard to (2), the facts were as follows. Of the 13 civilian cases
(including the two secondary cases) where there was a history of recent
contact with a soldier home on leave in the same house 13 cases, or 68 per
cent., were fatal: whereas of the 16 cases where no such history was obtained,
7 cases, or only 44 per cent., were fatal. The two soldier cases, however, both
recovered.
In regard also to the possibility of certain cases of sore-throat or catarrh
being mild and non-meningeal instances of meningococcal infection, our
results are mainly negative. In one case, related in detail below, a contact
with an influenza-like illness which appeared as a possible source of infection,
proved to be " carrying " the germ, but in most instances the persons living
in the same family or house as the patients did not seem to be more affected
with catarrhal conditions than an average family.
It may be of some interest to give the details in regard to the cases which
were followed by secondary cases :—
(a) J.C. (aged 15), a soldier discharged from the Army on the 9th
February, fell ill at home on the 17th February, became unconscious
the same day, and was removed to hospital on the 23rd February
with cerebro-spinal meningitis. A few days later, his mother (Mrs.
C., aged 40), developed a sore throat with influenzal symptoms, and
on the 3rd March, E. C. (aged 5), sister of the first case and daughter
of Mrs. C., suddenly fell ill, and was removed to hospital the same
day with the disease. On swabbing Mrs. C's throat, meningococci were
found. The first case (J.C.) recovered, but the little girl died.
(b) C.H.D. (aged 18), a soldier home on leave from France, became ill on
the 1st March, and was removed to hospital next day with cerebrospinal
meningitis. On 29th March his sister, M.L.D, (aged 4) was
taken ill, removed to hospital, and died next day of a fulminating
attack. On the 1st April the first case, C.H.D., returned home, and
he and seven other persons in the house were swabbed. All were
negative except C.H.D., from whose throat the meningococcus was
obtained. Several persons in the house, however, had had catarrhal
colds. While C.H.D. had been in hospital most of the members of
his family visited him, but the second case, M.L.D., had not done so.
(e) E.E.E. (F., 13½) had headache and malaise on the 21st May. She
became better, but fell suddenly ill on the 31st May, and died at