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21
Most of the multiple cases were very mild ones, and probably
would not have been detected in the absence of bacteriological
examination, the clinical symptoms being very slight. These
examinations also brought to light the fact that there were a
considerable number of "carriers" amongst the children.
On the receipt of a notification I always endeavoured to trace
the infection back to its source; the work in this connection
necessitating the visitation of 258 contacts and suspects; and
although impossible in every case, I was able in many instances
to prove that some apparently healthy child was the innocent source
of the trouble, and was carrying Diphtheria germs in the throat or
nose; while in other cases 1 found that a child who had at some
previous time suffered from the disease and quite recovered, had
again become infected with the bacillus.
The following special report which I made to the Council on
23rd October tends to support this view :—
"The history of three cases of Diphtheria which occurred
"recently in the District so clearly demonstrates the indispensa"bility
of careful bacteriological examination of all contacts, and
"at the same time so aptly illustrates the difficulties besetting the
"path of the Medical Officer of Health in his efforts to check and
"prevent the spread of infectious diseases, that it seems to me
"worthy to be made the subject of a special report to the Council.
"The facts are shortly as follows :—
"S.D., a small boy, 7 years of age, was taken ill on June
"17th, and was treated at home by his parents until the 26th,
"when they, not being satisfied with the way he was progressing,
"called in a doctor; a throat swab was taken, sent to me for
"examination, and gave a positive result; the case was accordingly
"notified as Diphtheria, and removed to Hospital on June 28th."
"E.C., a boy aged 4½ years, living next door, was taken ill
"on June 24th, and the mother called in the doctor in attendance
"on S.D. A swab from this case also proving positive, the boy
"was removed to the Hospital on June 29th. All other children
"were swabbed, with a negative result. The strictest inquiries
"failed to show where S.D. had contracted the disease. The
"usual steps were taken for disinfecting the houses."
"S.D. returned home on August 10th, and a swab taken on
"August 20th proved negative. E.C. returned home on September
"23rd, but owing to some mischance I was not made aware of the
"fact until October 12th.
"On October 10th, T.D., aged 5 years, a brother of S.D., was
"taken ill with Diphtheria, and removed to Hospital on the 12th.
"On October 14th I visited the houses and swabbed the throats
"and noses of all the children in both houses—six in all—with the
"following remarkable results:—