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The exclusion of such children from school and the adoption of suitable throat treatment promises
to give better control over diphtheria prevalence. As pointed out in a previous report, this administration
requires the unstinted use of the laboratory.
The reports of medical officers of health include accounts of local prevalences. In Stoke Newington
in 11 cases there was a history of antecedent recurrent sore throat in the person attacked, and in 2
cases the attack was preceded by sore throat in other members of the family. In Shoreditch in 27
instances antecedent sore throat was found in members of the family of the persons subsequently attacked,
or in other persons resident in the same house. Dr. Allan gives the particulars of a limited outbreak
among the children attending the St. George's School, Westminster, and Dr. Alexander of an outbreak
among the children attending the girls' department of the Atley-road School, Poplar; Dr. McCleary
records a small outbreak among the children in a boarding school in Battersea, and the finding of the
diphtheria bacillus in the throats of two children in the school not previously suspected to be infectious,
and one of whom had no clinical symptoms. Dr. Caldwell Smith gives account of the prevalence of
diphtheria among children in the Eardley-road school and in the Immanuel-road school, Streatham
Common. In both these schools children were found with the diphtheria bacillus in their throats,
and in the former closing of the infant school and in the latter closing of the infants' and girls' departments
was resorted to. Dr. Davies found in two houses in Woolwich, in which children were attacked,
antecedent cases of diphtheritic nasal discharge, the nature of which had remained unsuspected until
the subsequent cases occurred.
In connection with the question of the relation of school attendance to the spread of infection,
it has been thought well to include, as in previous reports, a table showing the reduction in the prevalence
of the disease among persons of school age during the summer holiday when the schools are closed.
The summer holiday of the schools of the London County Council began on Thursday, the 21st
July, i.e., the latter part of the 29th week, and the schools re-opened on Monday, the 22nd August,
i.e., the beginning of the 34th week. If the number of cases in the four weeks preceding and four weeks
subsequent to the weeks most subject to holiday influence be compared, the following results are obtained
for the age periods of 0-3, 3-13, and 13 years and upwards. It will be observed that the decrease
in the number of cases notified during the period of holiday influence and the increase in the subsequent
period is confined to the school age—

Many of the annual reports show the number of cases of suspected diphtheria in which
material from the throat was submitted to bacteriological examination and the results obtained.

In only one report, that relating to Battersea, are return cases stated to have occurred. In this
district there were two such cases. In many of the other reports it is stated specifically that none were
found.