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46
Department. The infection in the case of the child in the Infants
Department was probably contracted in the home, as another case
occurred in the family a few days previously. The course of the
disease in the Southfield Road junior School will be referred to
in a subsequent paragraph.
The other schools which suffered were the County School
Rothschild Road and John Perryn Schools. It is probable that the
infection in the John Perryn School was an independent one. The
type was not as virulent as that in the other schools, and there did
not appear to be in intimate connection between the cases. 8 case
occurred in John Perryn School, but there were no deaths.
The first case which occurred in the County School was in
a boy who resided in Bedford Park, and some of the cases were
similar in character to those which had occurred in Southfield Road
School. The type was probably modified, because the pupils were
older and it is well known that Diphtheria is more fatal in young
children.
4 cases occurred in Rothschild Road Infants Department in
October and 5 other cases occurred in the first fortnight in November.
There is a connection between Rothschild Road School and
Southfield School, the senior boys of Southfield School being
recruited from the Rothschild Road Junior School.
Up to the end of the year, most of the cases of school ape
occurred in these schools—^Southfield Road, Rothschild, John
Perryn and County. 3 cases occurred among Acton girls attendin;
Chiswick County School. These cases were also of a very virukm
type.
Cases occurred amongst children under school age in other
parts of the district. The ward distribution is given on another
page, but this was of less importance in the incidence of the disease
than the school distribution.
In the past four years outbreaks of extreme virulence have
been reported not only in this country, but in other countries
Europe. In this country, outbreaks of unwonted severity have
been reported from several parts, and in districts in and around
London outbreaks of the severe type of Diphtheria have occurred
It has been suggested that Diphtheria generally is entering upon
a more severe stage. If the disease is about to vary in virulence
the first indication will be increased variation in local fatality. In
the last few years, the numbers of districts which record rates higher