were noteworthy, not for the number of cases, as only 6 cases altogether
occurred, but from the severity of the symptoms, as two of
the children died.
The first case was notified on September 26th, and the
second on September 27th. Both children attended the same class,
and on September 29th, all the children in this class, to the number
of 56, were swabbed.
Two swabs were found to be positive, and in one of them the
culture was almost a pure growth of the Diphtheria bacillus. On
further examination of one of the children in whose throat the germs
had been found, she was found to be suffering from a sore nose
and swollen glands of the neck. From her appearance there could
be no doubt that she was a clinical case of Diphtheria that had been
missed. The other children in the house were examined and in all
probability, two of them had also suffered from a missed attack of
Diphtheria. Swabs were taken and in both instances they contained
the bacilli associated with Diphtheria.
In the other case attending the class implicated, in which a
positive swab was obtained, the child was probably only a carrier,
but she was excluded from school until negative swabs were obtained.
No further cases occurred in the school, and it seems probable,
if not certain, that the two fatal cases arose from association with
one or both of the children in which a positive swab was obtained
and who were excluded as a result.
This is not an isolated instance; similar incidents constantly
occur. Possibly in no sphere of preventive medicine, can bacteriological
knowledge be so successfully applied in the prevention
of the spread of disease as in the case of Diphtheria. In almost
every instance, the means and the methods adopted are successful,
and yet, not infrequently we have complaints from parents. Sometimes
they object to the swabbing of the throat, and frequently
they protest in vigorous langauge against any suspicion that their
children can in any way be responsible for the spread of the disease.
Their objection, of course, is due to ignorance of the true facts or a
misunderstanding of our motives. The fact that a child may have
had an attack of Diphtheria which was missed, does not necessarily
imply that the parents have been remiss or neglectful. The attack
may have been so slight as to escape detection.
Ophthalmia Neonatorum. 4 cases were notified. One of
them was a severe case and was admitted into the Acton Hospital
for treatment from June 26th to July 10th.
All the four cases made a good recovery, and the sight was
not permanently affected by the disease.
Encephalitis Lethargica.—6 cases of Encephalitis Lethargica
were notified, and 3 deaths occurred. Another of the cases