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74
The percentage of cases occurring among school children is
higher than that in any year since 1909. Last year the percentage
was 56.3, compared with 49 in 1912, 55 in 1911, 56 in 1910, and
60 in 1909.
It was only necessary in one instance to make an examination
of all the children in a suspected class. A few virulent cases
had occurred in Acton Wells School, and all the children with
suspicious sore throats in the affected classes were examined; as
a result, 2 children were found who were harbouring the
Diphtheria bacillus. These children were excluded from school,
and the notifications ceased.
At the beginning of 1913, though, a systematic examination
of all school children from houses where a case of Diphtheria had
occurred was carried out. The usual period of quarantine was
observed. The other children in the house were excluded from
school for 8 days after a case was removed to the Hospital; or
where the case was nursed at home, for 8 days subsequently to the
disinfection of the premises at the end of the illness. At the end
of the quarantine period all children from infected houses come to
the offices, and a swab is taken from each throat. Last year 187
contacts were examined in this manner, and of these 30 were found
to harbour the Klebs-Loeffler bacilli. The figures are, of course,
too small to draw any conclusions, but it will be readily appreciated
how easily the disease is kept alive in a community, and how
difficult it is to stamp out the disease in a school once it gets firmly
established there. The behaviour of the contacts made it appear
highly probable that the disease is kept alive in the community
and fresh outbreaks lighted up chiefly by infected individuals who
mingle with their fellows. The percentage of positive contacts
varied at different times of the year, but a high percentage was
shortly followed by an increase in the notifications in the district.
Whenever a "contact" is found to be positive, he or she is
excluded from school, and a further examination made at the end
of another week. Altogether 220 swabs were examined from the
throats of contacts; of these 172 were negative and 48 were