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Other bacteriological examinations carried out were 47 for the tubercle
bacillus in sputa, of which 12 shewed its presence; 2 examinations of hairs
for ringworm, the organism being present in both; and 6 examinations of pus
from the eyes of the new-born for the prescence of gonococci.
"Carriers" of diphtheria germs were usually sent to the Isolation
Hospital; this was necessary in all cases sent, on account of the presence of
numerous other children in the house. For instance, in one street where eight
cases of diphtheria had occurred, I found that the average population of the
infected houses was 13. In the same street the average population of 100
houses where the sanitary inspector had recently been, was 9.
In only a few cases was it possible to keep carriers at home. In two
cases where the nose was affected and where adenoids were present, the
surgeon in charge of the Throat Department at the Prince of Wales' Hospital
kindly made the necessary arrangements for their removal.
Return cases of diphtheria have given no trouble during the year; as far
as I know, there has only been one such case.
There is, however, one difficulty in regard to nasal cases, and that is, that
whilst in Hospital local treatment apparently gives negative results when
swabs are taken, but that, on being home for a week or so, the organisms get
the upper hand and the child is easily recognised as a nasal carrier.
The Schick test has not been used for any cases, but the question of
artificial immunisation against diphtheria is worthy of consideration. In my
report to the Public Health Committee in December, 1925, with reference to
the appointment of a Deputy Medical Officer of Health, there is this passage:
"The treatment of diphtheria is altering considerably by the method of active
immunisation ; this is bound to come sooner or later, and it is probable that
scarlet fever may rapidly follow."
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