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time of the occurrcnce of a case in a house, a leaflet is left
pointing out the advisability of the parents having their children
so treated. Very few requests have, however, been received
and up to the end of the year no children had been tested or
immunised.
Bacteriological Examination.
541 swabs were examined during the year at the Essex
County Public Health Laboratories.
Schools and Diphtheria.
In two years 1927 and 1928, there were 135 cases of
Diphtheria occurring amongst school children. Included in this
number were:—
1. 17 cases associated with a definite school outbreak lasting
for five weeks, in which the figures were in each week,
2, 7, 4, 3 and 1, an outbreak thought to have been initiated
by a convalescent carrier.
2. Definite instances of school infection occurring where a
positive nasal swab was obtained of a child attending,
and in each case this infecting child causing the disease
in members of his family; in one case, two, and in another,
three of the family.
"1 the other cases amongst scholars, 20 were children in
school attending a department in which a case had occurred
recently. Of these only 13 occurred within a period of ten days
lr°m the last attendance of the previous case (memorandum
"'led by the Ministry of Health and Board of Education gives
'^'incubation period of Diphtheria as 2 to 10 days).
these only 11 were class mates. In ordinary circum|Unccs
it does not seem that the ordinary clinical case of
p'htheria spreads to any extent in school. There were at
ast 7 rases of Diphtheria who attended school for some period
Ceding one day after the onset, and followed by no other
<"id also one instance of a nasal Diphtheria who attended
1 'wo weeks without giving rise to any spread of infection
1,1 school.
Scarlet Fever.
340 cases of Scarlet Fever in a population of 67,500 is at
'ate of 5.05 per thousand living, compared with the figure
-61 for England and Wales. The figures of incidence per
! " children underl5 are 1.4 times that of the country as a