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105
Another interesting point illustrating the part played by the family in disseminating the
infection of Diphtheria in spite of the prompt measures taken to control the spread is that 46 per cent,
of the total number of adults affected could definitely trace their infection to a preceding case or cases
occurring among the children in their families.

Hence the majority of adults were infected from children suffering from the disease during
the period which elapsed before the case came to the notice of the Sanitary Authority and was removed
to Hospital.
This therefore shows that family infection has as usual played an important part in spreading
this epidemic.
THE TYPES OF DIPHTHERIA MET IN THIS EPIDEMIC.
Of the 133 cases notified it was found that while undoubtedly 106 (excluding 1 case notified as
Diphtheria and removed to M.A.B. Hospital of which we have no report) suffered from true Diphtheria
Bacillus affections, the remaining 26 cases (with a few exceptions) suffered from what subsequently
proved to be non-diphtheritic inflammatory affections of the respiratory tract.
The cases were classified according to the extent of the local lesion, the amount of constitutional
disturbance and the presence of complications into 5 types, viz., Very Mild, Mild, Moderate, Moderately
severe and Severe.
Thus 3 were found to belong to Very Mild type.
35 „ „ „ Mild
28 ,, „ ,, Moderate ,,
14 ,, ,, „ Moderately Severe type.
23 ,, ,, ,, Severe type.
Thus while the majority of the cases were mild in type, 23 had severe attacks with marked
toxaemia or lung complications on admission or who subsequently developed serious paralysis.
The Mortality Rate.
The Mortality Rate in this epidemic was as follows :—
In adults, Nil.
In children, 0—5 years, 20 per cent., 6 cases being fatal out of 30.
In children attending school, 11.1 per cent., 7 cases being fatal out of 63.
In considering this Mortality Rate, it is interesting to correlate the type of the attack with the
corresponding Mortality Rate for that particular type, viz.:—
Type. No. Fatal. No. Survived.
Very Mild 0 3
Mild 0 35
Moderate 0 28
Moderately Severe 0 14
Severe 13 (56.5 per cent.) 10
This table therefore, demonstrates that it was only these patients who contracted the disease
in its severe form who succumbed.
Carriers.
Of the total number of cases there were found to be 3 carriers— 2.8 per cent.
(In calculating this rate the case D. B., who contracted Diphtheria in a moderate form, was
admitted to hospital on 20.12.25 and discharged on 6.2.26, and re-admitted as a carrier on 16.2.26,
is included as a carrier.)