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1934] 34
be traced afterwards. In a number of cases the source of infection was traced to
contact with a fellow worker, and in one group three cases were workers who
w ere dealing with paper. Subsequent cases to the number of 4 or 5 frequently
occur owing to the refusal of vaccination, or delay in having it done, on the part of
contacts. In one instance the husband, although quite well, appears to have
carried the infection from his workplace to the home, as his wife contracted the
disease.
Classification as to source of infection.
Infection from previous cases 38
Infection from common lodging houses —
Infection from school 8
Smallpox in the neighbourhood 1
Infection from workplace 4
Infection not traced 15
Contact with cases in other Boroughs —
Infection in hop fields —
Infection from hospital —
Infection possibly from " missed " case 3
Unverified cases 1
Total 70

Diphtheria was responsible for 811 cases of illness, which were 7 above
the average (804) of the preceding ten years. The attack rate was equal to 2.58
per 1,000 of the civil population annually, and was 0.13 above the mean rate (2.45)
of the decennial period. In London the attack-rate was 2.5 per 1,000.
DIPHTHERIA ANTI-TOXIN; IMMUNISATION.
Under the Special Order of 15th August, 1910, the then Local Government
Board sanctioned the provision by the Sanitary Authority, in pursuance of
section 77 of the Public Health (London) Act, 1891, of a temporary supply of
Dip htheria Anti-toxin " for the poorer inhabitants of the district, subject to the
fol jwing conditions, that is to say, the arrangements with respect to the keeping,
distribution and use of the Diphtheria Anti-toxin shall be made in accordance with
the advice of the Medical Officer of Health."