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30
DIPHTHERIA : (Including Membranous Croup).
(Total deaths 87. Decennial average 95.)
The number of cases reported under the two heads was 543, the
deaths registered were:—
Diphtheria 81
Membranous Croup 6 = 87
This indicates a mortality rate of 16 0 on the notifications. On
the estimated population at all ages the mortality was 0 67 per
thousand living, giving almost identical results with that of the
previous year, while the general Metropolitan rate was 0.50.
Of the cases 214 were reported from the North district with 30
deaths ; 184 from the South with 26 deaths; and 145 from the East
with 25 deaths.
In 252 instances the residence of the patient was found to be in
a satisfactory sanitary condition, but in 141 the closets were
defective ; in 17 the external drainage was faulty; and in 30 the
drains inside the house were leaky; whilst various other insanitary
conditions were noted in 198 instances; 64 cases occurred in
families occupying one room only.
Out of 256 cases removed to Hospital 37 died.
Some of the cases notified as diphtheria were reported by medical
men who did not take the trouble to warn their patients as to the
infectious nature of the disease from which they were supposed to
be suffering. Under these circumstances the instructions of the
Sanitary Inspector as to isolation were sometimes received with
indignation, perhaps followed by an appeal to a second medical
opinion for confirmation or refutation. It should not be forgotten
that a person may have well.marked diphtheria without at first
feeling very ill, and that if he exposes himself in this condition
he will be certain to spread infection. It is sometimes impossible
to make an absolutely certain diagnosis by a mere inspection of the
throat, but proper isolation of the true disease is none the less
imperative. It would be a great help to me if I were authorised to