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It is of course possible, that the infection was harboured in the
ward, and it may be mentioned that when the Cottage Hospital was'
emptied and the place thoroughly disinfected, no further cases
occurred there. On the other hand, it seems that a few days after
D. M. was removed to the Isolation Hospital, W. K. had a slight
sore throat; he was thoroughly examined, but there was no other
symptom of Scarlet Fever.
The outbreak has been dealt with at considerable length, as
some of the matters discussed involve details of great importance
from an administrative point of view. It is obviously insufficient
to exclude from school and to isolate acute cases only, when there is
sometimes the possibility of a person harbouring the infection for a
prolonged period. It is proved that the germs of Typhoid and
Diphtheria have been harboured for years by a very small
percentage of the persons who have suffered fromthe disease, and a
similar phenomenon is not impossible in Scarlet Fever.
The age incidence and the ward distribution of the disease are
given on Table III.
DIPHTHERIA.
Eighty-three cases of Diphtheria were notified and 7 deaths
were caused by the disease.
There is a slight increase both in the number of notifications
and deaths.
The disease was fairly uniformly distributed throughout the
year, and in no instance did an outbreak of the disease assume
serious proportions. Diphtheria is a disease which stands out in
striking contrast to some of the other infectious diseases such as
Scarlet Fever, Measles and Whooping Cough. Although the latter
diseases have been known for a long time, our knowledge of them is
limited. The specific germs have not been isolated, and their mode
of spread is open to argument. We are in a far happier position
when dealing with Diphtheria. Not only is its microbial origin
fully proved, but we have means within our reach which enable us
to deal with outbreaks of the disease. Diphtheria is only acquired
directly or indirectly from another case, and cannot arise from bad
drains or insanitary conditions, though the latter conditions may
predispose by lowering the resistence.