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75
positive. Some contacts were found to be positive for a considerable
time, but in the majority of instances the swab was
negative on the second examination.
Although it was not found necessary to examine systematically
the throats of children in more than one school, the search for mild
sore throats amongst scholars has been more stringent, and the
Teachers exercise very great care to prevent any children with sore
throats from attending school. How necessary this precaution
was, is made evident from the result of the bacteriological
examination of the swabs taken from children sent to the offices
by the Teachers and the School Nurse. 190 children were
examined, who had been sent by the Teachers on account of sore
throats. Of these, in 33 instances the Klebs-Loeffer bacillus was
present, and in 127 instances it was absent.
It is impossible to give an estimate of the percentage of
virulent cases amongst these positive contacts and sore throats,
as the final test of virulence must, of course, depend upon the
result of infection of guinea pigs, but out of the 63 there must
have been a considerable number who were in a highly infective
condition. Some of them were in the early stages of a typical
attack of Clinical Diphtheria, and were isolated in the Fever
Hospital.
The point we wish to emphasise is, that the most hopeful
ground for the control of Diphtheria generally lies in the school,
and it is highly probable that this disease would be almost entirely
stamped out if a systematic examination were made of all contacts,
not "house-contacts" as at present carried out, but also "classcontacts."
The percentage of "class-contacts" who would be
found positive on examination is probably a higher one than we
are led to believe The mild and the carrier cases are those which
it is of the greatest importance to identify, especially in schools,
for, if not recognised, the children may go about and prove a source
of infection to all around.