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Two of the cases were carriers. The three cases in which
clinical signs were present were very mild, and their stay in hospital
was 9 days, 24 days and 25 days respectively.
There were 3 cases in which the children had had one
inoculation—1 of these was inoculated on the day before the notification.
Diphtheria had occurred in the house and the parents wished
the child to be inoculated. The two others had received one
inoculation less than 3 weeks before notification.
WHOOPING COUGH.
Throughout the year 1937 whooping cough was prevalent in
the district, and although there were only three deaths registered as
being caused by the disease, it resulted in much interference with
the work of the infants' departments of the schools, and especially
that of the nursery schools and the day nursery. Whooping cough
does not cause as many deaths as Measles in Acton, but owing to
the length of time in which a case is infectious, and also the lengthy
periods of its maximum incidence in a district, it causes more
interference than most other diseases in day nurseries and infant
schools.
Whooping cough is notoriously one of the most difficult
diseases to control and treat. Its prevention arises from the difficulty
of diagnosis; in its early stages clinical diagnosis is not only difficult
but almost impossible; the cough at first does not differ from the
ordinary coughs which are prevalent amongst children in the colder
months, and it is well-known that whooping cough is infectious from
the early catarrhal stage of the cough, and before the appearance
of the whoop or of spasmodic attacks. What is considered its sole
characteristic is late and inconstant in its appearance. It has been
suggested that the name whooping cough should be abandoned, and
it should be called pertussis to wean the obsession of the medical
profession that a whoop is essential. In a recent school epidemic
one-fifth of the cases did not whoop at all and did not even have the
recognisable spasmodic coughs.
The difficulty of diagnosis in these cases, of course, is obvious
in most epidemics these cases are a very small minority; but, as
stated, even in those who develop the characteristic whoop, early
diagnosis and segregation is almost impossible by clinical method
alone. For many years bacteriologists have worked at the problem.
and it seems likely that they have succeeded in isolating the germ
which is the cause of the disease. The claims of the bacteriologist
that the specific bacillus of whooping cough has been isolated were