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16
Home Return Cases—Scarlet Fever.
No return cases were traced during the year in connection with
the small number of patients treated at home.
3.—DIPHTHERIA.
Out of 222 cases notified on account of diphtheria, 211 were
treated at the Borough Hospital and 11 treated at home. 8 cases
notified as diphtheria were also admitted from the Penge U.D.
The Croydon cases under treatment were as follows:—
Admitted with faucial diphtheria 114
,, naso-pharyngeal diphtheria 27
,, laryngeal diphtheria 6
,, nasal diphtheria 12
,, as carriers 37
The remainder of the patients admitted on a notification of
diphtheria were found after admission to be suffering from diseases
other than diphtheria.
7 deaths occurred from diphtheria at the Borough Hospital,
and 1 in a home-treated case, giving a case mortality of 3.6 per
cent. This is markedly lower than the case mortality from diphtheria
of 12.7 per cent. among cases notified in 1923. Early in 1924
the attention of medical practitioners was drawn to the need for
anti-toxin treatment at the earliest possible moment of the disease,
in many cases even before the bacteriological diagnosis has been
completed, and it is likely that the response to that appeal had a
material influence on the case mortality from diptheria during the
year.
The average duration of stay of all diphtheria cases in hospital
was 50.2 days. This somewhat prolonged period is due to the
patients including an unusually large number who, after an ordinary
attack, continued to show virulent diphtheria organisms in
throat or nose over prolonged periods, and whom it was necessary
to retain in hospital until clear of infection.
Two cases of laryngeal diphtheria underwent the operation of
tracheotomy. Both were severe cases; one died two days later from
heart failure, the other recovered.
Hospital Return Cases—Diphtheria.
One return case occurred during the year secondary to discharge
of a patient from the hospital after an attack of diphtheria.
The infecting case was found to yield a nasal swab containing diphtheria
bacilli, and was readmitted to the hospital.