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55
Diphtheria;—The number of cases of diphtheria was less
than in the previous year, only 83 cases being notified, compared
with 129. The diphtheria case-rate for Ealing was 0.72 per
thousand of population, this rate being well below the case-rate
for England and Wales, which was 1.27. As will be seen from
Table VI, diphtheria was not very prevalent at any time of the
year, the greatest number of cases notified in any month being 12,
in March. The least number of cases occurred in the months of
February and November, in each of which only three were notified.
There were five deaths from the disease, giving a death-rate
of 0.04 per thousand of population and a mortality-rate of 6.0 per
cent. of cases notified. The death-rate is below those for England
and Wales, the 117 Great Towns, and London, which are respectively
0.07, 0.08 and 0.06.
Recovery from diphtheria depends mainly on the promptitude
with which the specific remedy, diphtheria anti-toxin, is administered.
A study of the circumstances attending the five deaths
which occurred last year suggests that anti-toxin was not administered
sufficiently early in the majority of them. Two main
reasons are usually responsible for delay, the principal being the
failure on the part of parents or guardians to realise that their
child is seriously ill and requiring medical attention. Consequently
a doctor is not called in until the disease is too far advanced
for successful treatment. Although the lesion in diphtheria
is most frequently situated in the throat it is by no mean;
always accompanied by pain, and the attention of the parent may
not be directed to the cause of illness. The throat of an ailing
child should always be examined and where there is the slightest
doubt about the cause of the illness, medical aid should be sought
at once. The recognition of the disease is not always easy, even
to the skilled physician, and the second main reason for delay in
administering serum is the failure of the doctor to do so until he
has had bacteriological confirmation of the diagnosis, or until the
diagnosis is obvious. Where there is the slightest suspicion of
diphtheria anti-toxin should be administered at once. The possibility
of untoward results from the administration of anti-toxin,
should the case prove not to be one of diphtheria, is very remote,
while the immediate benefit to the patient if it is one of diphtheria
may be vital.