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one case, owing to lack of beds, it was necessary to commence
home treatment of a patient who was admitted shortly after.
These 213 cases are an average of 4 per week, the greatest
incidence being in the first two and the last two months of the
year. No particular school or locality suffered to any extent.
Of the primary cases 167 were on the Estate (out of a
population of 24,000 children) and 12 cases in other houses
in a population of 3,750 children, so that this year the incidence
fell much more heavily in proportion on the Estate
houses.
Secondary Cases.
In 17 houses there were 24 secondary cases, i.e., 14 primary
cases gave rise to one secondary; in two instances, two cases
followed, and in one 3, in one house one of the secondaries was
missed and infected others, and similarly, where 4 secondary
cases occurred probably through the initial secondary infecting
three others, or others passing it on.
In 5 cases the secondary was diagnosed when the Doctor
called in to the primary case. In three instances the
primary was a nasal Diphtheria and another case recognised
positive swab and the history.
In other instances the primary case in 8 out of the 11 was
not removed before the fourth day.
24 secondaries from 213 primary cases is 9o/o, decidedly
less than last year.
Of 142 primary cases giving rise to secondaries, 73 were
removed before the fourth day, and 69 on fourth day or later.
Influence of crowding on production of secondaries.
In the 145 instances where there were primary cases only—
the average population per house was:—under 15, 2.76; over
15, 2.26—occurring in an average of 2.45 bedrooms. 1.49
living rooms.
In those 19 instances where secondary cases occurred, population
under 15—2.79, over 15—2.26, occurring in accommodation
" 2.23 bedrooms, 1.33 living rooms.
Return Cases.
The following is a summary of the 8 return cases occurring
in the discharge of six patients: —
Female 9, removed third day, in hospital 29 days; on
leaving she had a typical nasal discharge with positive