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9
Another small but well-defined group of cases
occurred in November. It was clearly a school attendance
group, and consisted of four primary and two secondary
cases, all occurring about the same time and all attending
the same school. The outbreak ceased on the temporary
closure of the school in question. To these should be added
a case of sore throat, to which no medical practitioner was
called in, and a case of septic sore throat which was under
my own care, and which was not, in my opinion, Diphtheria.
I had attended this child in a well-marked attack of Diphtheria
in a previous year. All these children not only
attended the same school, but when at school were in the
same class room—an apartment well lighted and ventilated,
and having an available cubic space of about 1,500 cubic
feet—the average number of children in it during class
time was given as 14, shewing some aggregation ; but this
was minimised by the children not being in the room more
than two hours consecutively, and by the windows being
thrown open in the interval. The drainage of the premises
was examined and found defective, as was also that of the
adjoining house. I am not of opinion, however, that the
outburst was caused by the defective drainage, because
when a volatile test was applied to the drain the smell was
strongly perceived in the class room on the first floor, and
not one case occurred among the children using this room,
while no smell whatever could be detected in the room used
by the children who contracted the disease. I regard the
outbreak as due to the accidental introduction of an infected
person, probably a child suffering from a mild attack, into
the room. Instances of Diphtheria outbursts preceded by
cases of ill-defined throat illness are not uncommon.
No deaths occurred as the result of this outburst.
It is worthy of remark that one of the earlier cases
had been twice previously notified to the Sanitary Authority
as suffering from Diphtheria, and once as suffering from
Scarlet Fever, during the two preceeding years.
The whole of the defective drains were taken up
and re-constructed before the school was re-opened.
The other primary cases were sporadic in character,
and occurred at different times and in different localities.
Two of them were associated with Scarlet Fever;
one occurred in a house in Tramway Avenue, and in the
adjoining house was a fatal case of Scarlet Fever, and the
other was a case with which were associated two secondary
cases, all three children having been notified as suffering
from Scarlet Fever some 10 weeks previously.
Six cases occurred in Snells Park and Grove
Street at various times,