View report page

In the reports of medical officers of health it is shown that in Kensington a cab in one instance
and train in another were used for the conveyance of cases of diphtheria. In Battersea it
was found that a child suffering from diphtheria was in attendance at a general hospital in another
district, to which it was conveyed in a perambulator. The hospital authorities were duly cautioned.
The medical officer of health of Paddington gives account of seven "return" cases of
diphtheria, and states that material from the throats of three was examined bacteriologically with
negative results.
Special outbreaks of disease not appearing to be associated with elementary schools are referred
to in the reports of the following districts—
Westminster—During April, May, and June 21 cases of diphtheria occurred among the boys
resident in the Newport Market Refuge School, Coburg-row, nine boys being attacked in one
week. The disease appeared to have been introduced into the school by a boy who had been previously
visiting a house in the country in which a case of diphtheria had occurred during his visit.
Strand—Account is given of an outbreak of diphtheria in a home in St. Anne's. In dealing
with this outbreak much use was made of bacteriological examination for the purpose of
diagnosis and of antitoxin with a view of preventing attack. Dr. Allan's statement is as follows—
The outbreak in question occurred in an institution accommodating sixty children varying in age
from one and three-quarters to seventeen years. Most of them slept in two large airy dormitories and
the class-rooms occupied during the day were also large rooms. Early in February, 1898, one of the
children, during a visit to a friend, was exposed to infection from a case of diphtheria, and returning
home the same day. developed the disease herself and communicated it to the girls in the beds on each
side of her own. These three cases were early recognised and removed to a hospital, and no further
cases appeared until a few days after their return home in the beginning of March. The first of these cases
did not attract attention for some days, and by March 23rd five cases cropped up in the same dormitory.
A bacteriological examination of the throats of the three former cases revealed the fact that two of
them contained typical diphtheria bacilli. These children were promptly isolated, and the others having
been removed to hospital, it was hoped that the outbreak had been checked. On April 22nd, however,
several cases were recognised, and then it was discovered that in the interval three girls had suffered
from inflamed throats with some fever, but no formation of membranes. (It should be stated that a
medical man was only called in when those in charge thought necessary, and unfortunately at this time
the regular medical attendant was himself ill.) Under the circumstances I thought it desirable to
obtain permission to examine all the children remaining in the institution, and took_ swabbings from
their throats. Bacteriological examination disclosed that 27 throats had the diphtheria bacilli therein
more or less plentifully, many yielding pure cultures of typical bacilli. In 6 instances the result was
indefinite, and in 14 instances the bacilli were not isolated. The children were then divided into three
groups and restricted to separate parts of the building. I suggested that a protective dose of antitoxin
should be given all round, but it was not possible to do this until April 29, by which time eight children
had developed the clinical symptoms of diphtheria and several others had inflamed throats without
membrane. Oases had been occurring daily, but after the injection, although the organisms persisted
in the throats, there were no more cases of diphtheria or of sore throat. Bacteriological examination of the
throats of the children remaining in the home was made from time to time. At the second examination
five of those apparently clear at first yielded the bacilli, showing that it is not safe to accept a
negative result on the strength of one examination; of the 60 children, 9 only never gave evidence of
infection, 14 were in hospital, leaving 34 children at home in addition to the first 3 returned from