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35
It has been shown conclusively that a certain proportion of
those who are brought into contact with Diphtheria patients harbour
the bacilli in their throats or nasal cavities.
The percentage is highest in the immediate contacts, that is, in
members of the same family; it diminishes rapidly as we enlarge
the interpretation so as to include school-fellows and when the term
is so widened as to include such extremely remote contacts as the
general inhabitants, the percentage showing the bacilli is a
negligible one.
The following instances show the importance of carrier cases in
spreading the disease, and the desirability of making a bacteriological
examination of the immediate contacts.
Last July, several cases were notified from St. Alban's Avenue
and Rusthall Avenue. These children were all in different classes;
but an examination of the other members in the families revealed a
carrier case. The isolation of the latter was followed by an
immediate cessation of the notifications.
A similar phenomenon was noticed in Valetta Road, but usually
the disease assumes more formidable proportions when a carrier
case attends school. There were no extensive outbreaks in any of
the schools during the year, but probably this was in part due to
the action taken to detect any carrier cases.
On the re-opening of Rothschild Road School after the summer
holidays, two cases were notified, and both children attended the
same class. Swabs were taken from the throats of some of the
other children, and this revealed two other cases of Diphtheria.
The exclusion of these cases from school stopped the notifications
among the pupils of this school.
ENTERIC FEVER.
Fourteen cases of Enteric Fever were notified and two deaths
occurred.
In most of the cases, the disease was introduced from some
outside district.
Two persons were infected in Hadlow, Kent. One of these
was a resident of Hadlow, and came on a visit to his brother in
Acton on October 3rd, but had been ailing for some days prior to his