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in the previous year, or a rate per thousand under 15 of 2.63.
The rate per thousand population in England and Wales was
1.08 or per thousand under 15, 4.15. The incidence of diphtheria
in the district compared with that of the country as a whole was,
for all ages 1.02, but for the population under 15 years of age 0.63.
There were no return cases and only 4 secondary cases. In
each instance the onset of the secondary occurred before the
removal of the primary case—in fact, in all four cases the primary
and the secondary were both removed together. The alleged
origin of the secondary was on the 2nd day of the illness of the
primary in two cases, the 4th in one and the 5th in the remaining
case.
There was no difficulty in admitting the cases to hospital.
Only one case was treated at home, that being at the election of
the parent.
A few cases of diphtheria were associated with measles, of
which there was an outbreak in the early months of the year; four
cases were of pure laryngeal involvement.
Death Rate.
There were only 3 deaths (2 male and 1 female) recorded
during the year, this giving a case mortality of 2.9 per cent.
Not one of these cases was removed to hospital within the 4th
day from the alleged onset.
Bacteriological Examination.
361 diphtheria swabs were examined during the year at the
Essex County Public Health Laboratories, and 194 at the Public
Health Offices.
Schools and Diphtheria.
In no instance did a patient suffering from diphtheria appear
to have contracted the disease at school. Out of the 104 cases,
66 occurred amongst children who were not at the time they were
infected attending school. There were during the year no suspicious
groupings of infection, there being only one instance in
which two children attending the same department of a school
succumbed to infection in consecutive weeks.
No schools were closed during the year on account ot this
disease, and no schools or school rooms fumigated.