View report page

The dates of notification of cases in this table show several intervals of a fortnight or thereabouts
of freedom from the disease among the children at this school; thus, after September 17th,
November 18th, and December 11th. In view, however, of what has already been stated in regard
to unrecognised or trivial attacks of diphtheria, as well as of the fact that the information obtainable
from parents at the time of inquiry, does not always admit of definitely fixing the date of
onset of illness, or of last attendance at school, it can hardly be asserted that the school became,
during these intervals, free from risk of infection.
Other circumstances having possible relation to the occurrence of the disease.
Inquiries made as to milk supply did not show that there was anything in common amongst
the houses affected. The fact, also, that the cases were spread over a period of several weeks is not
suggestive of an outbreak due to milk.
As regards the general sanitary circumstances of houses and the drainage, it is to be
observed in connection with the former, that the greater number of cases occurred in the older part
of the district and amongst the poorer class of houses, but these vary considerably in character,
and there is no evidence indicating any connection between general sanitary condition of premises
and the special increase in the disease during the period under consideration.
Summary.
The incidence of cases during the special period is chiefly upon children of school age, and
comparing "primary" with "subsequent" cases the tendency of the disease to attack children of
this age is well marked.
In a part of Woolwich, which for a period of four weeks—that is during the period of
school closure for holidays—had been free from notified diphtheria, a case occurred at the end of
August. This case was, in all probability, contracted outside the district. From this date onwards,
however, cases continued to be notified in the district-.
The majority of "primary" attacks in houses was amongst school children attending six
schools, and of these 64'7 per cent. were among children at Powis-street School.
At Powis-street School the disease first occurred early in September, and continued to
attack scholars throughout the period under consideration. At other schools the number in each
case was small, and at Union-street School, which is in the same school area as Powis-street
School, only one case occurred. The area which these two schools serve is a small part of Wool-
* A sister of this case, aged 6, also a scholar at Powis-street school, 1st standard, was taken ill about
October 22nd with sore throat, and stopped away from school till after January, 1899. Her complaint was not
considered diphtheria at the time, but she afterwards suffered from difficulty of vision and paralysis. Another
sister aged 11, also attended the school, 5th standard. This girl did not live at home, but at 39, King-street.
Woolwich, but she used to go home for a few hours at a time and played with the above-mentioned sister, aged 6.
She was not ill, and attended Powis-street school throughout.
† This is not really a "first" case, though it is so according to notification return. The history of illness
at 27 Union-buildings is the following—About November 4th a female child, age 4, sister to above case, and also
a scholar at Powis-street school, infant department, was ill with a "cold " which was treated for a week by an
aunt. On November 11th a brother, also a scholar at Powis-street school, had a "cold." He died suddenly on
November 15th, and disease was pronounced to be diphtheria. The sister's complaint was then regarded as
diphtheria, and she was removed to the Brook Hospital on November 17th. The case (No. 17) in above list was
taken ill on the 14th November.