London's Pulse: Medical Officer of Health reports 1848-1972

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Croydon 1923

[Report of the Medical Officer of Health for Croydon]

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sore nostrils, without nasal discharge; 3 had developed nasal discharge
after leaving the hospital; 1, although showing no evidence
of infectivity, had a history of having had nasal trouble for many
Home Return Cases—Scarlet Fever.
No return cases were traced during the year in connection with
the small number of patients treated at home.
Out of 196 cases notified on account of diphtheria, 189 were
treated at the Borough Hospital and 7 treated at home.

The Croydon cases under treatment were as follows: —

Admitted with faucial diphtheria129
,, naso-pharyngeal diphtheria28
,, laryngeal diphtheria4
,, carriers20
,, nasal diphtheria7
,, eye diphtheria1
match: ALTO ComposedBlock
..\18 March 2013\Folder 2\b19786815\Tables\b19786815_0020_018_008.xml

In addition, 17 patients were admitted for conditions suspected
to be diphtheria, but finally diagnosed as follows:—12, tonsilitis;
1, scarlet fever; 3, laryngitis; and 1, stomatitis.
The patients admitted included an exceptional proportion sent
in at a late stage of the disease, often through failure of the parents
to summon medical help sufficiently early. There is evident
some tendency to rely too exclusively on the bacteriological diagnosis
of the disease, and to postpone the administration of antitoxin
until the result of a swab is known. It is undoubtedly
wise in all suspicious cases to give antitoxin as a precautionary
measure at the earliest moment possible, repeating and increasing
the dose if necessary when the diagnosis is confirmed by the microscope.
18 deaths occurred from diphtheria at the Borough Hospital,
giving a case mortality of 8.7 per cent.
The average duration of stay of all diphtheria cases in hospital
was 42.9 days; of the fatal cases, 11 days.
Antitoxin has been given chiefly bv the intra-muscular method,
the intravenous route being used only for toxic cases.

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