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45
Until September the disease could be said to have followed
a farly normal course. Its incidence was slightly higher than that
obseved in inter-epidemic years, but there were no cases of extreme
vorulence in the earlier part of the year. The deaths which occurred
were in young children—1 in an infant under 1 year of age, 1 in a
child in his second year and 3 in children between the ages of 2 and
5 years..
Although the spread of Diphtheria in recent years has
become associated with elementary schools, its fatality is still greater
amongest children under 5 years of age. When extensive outbreaks
occure. Diphtheria is typically a disease of schools and institutions
where children are brought together at susceptible ages. But
through its incidence is greatest at school ages its fatality is greater
at ages under 5 years. It is not common in the first year but it
becomes increasingly fatal, until the maximum morbidity is reached
somewhere between the second and fifth year. The incidence
declines slowly in the age group 5-10 years, after which the probaof
contracting Diphtheria is small.
Daring the earlier part of the year, the incidence of the
disease conformed with that observed in other parts of the country,
but the autumn the course of the disease was abnormal in many
respects. Its age distribution was different, but its most marked
characteristic was its extreme virulence.
The earlier cases all occurred among pupils attending
Southfield Road Junior School. Subsequently cases of a virulent
type occurred in other schools, but it is of interest that a connection
between these children and those who attended Southfield Road
School could be traced.
Of the two cases notified from pupils attending Southfield
Read School early in the year, one had occurred in January and
the other in March. Both were of a mild type and recovered.
After the summer holidays, the first case was notified on September
24th and four others were notified in September, the dates being,
September 26th—2 cases, September 27th—1 case, and September
28th- 1case. From the dates of onset of the latter 4 cases, it is
Possible that the infection was contracted on the same date, but if
at was a school infection, it was not a class infection. The children
were in 5 different classes. These 5 cases were all severe, and three
of them proved fatal.
In the first fortnight in October, 8 other cases occurred in
the school; 7 in the Junior Department and 1 in the Infants'