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ever, or very slight symptoms, which might or might not be
actually attributable to Diphtheria. Twenty such cases were
discovered by myself, or by Dr. A. E. Thomas, whom your
Council appointed temporarily to assist in this work, and 15
were discovered by Dr. C. J. Thomas, Assistant Medical Officer
of the London County Council, who examined the children in
several schools on my request.
The Medical Officers of the Royal Arsenal also examined employees
from infected houses before allowing them to return to
work, and discovered several bacteriological carrier cases. Altogether
22 cases, found to be carriers of the Diphtheria bacillus,
without having any symptoms, were notified. Twelve cases
were reported as nasal.
In addition to the notified cases a number of bacteriological
cases were discovered by myself and were not notified, but
isolation precautions were advised and carried out at home.
57. Source of Infection.—In 123 cases a probable source of
infection was noted, viz., in 50—other inmates of the same houses
were considered the source; 50 were attributed to school infection;
11 to infection by neighboxirs and friends; 11 were
"return cases," and one was employed at the Brook Fever
Hospital.
All but one of the return cases occurred in the first half of the
year and full details are given in the special report already
referred to.
58. Mistaken Diagnosis.—Twenty cases, or 7 per cent, of
notifications, were stated not to be Diphtheria after removal to
Hospital. The percentage in the two preceding years was 12 and
7 respectively.
59. School Infection.—Table VI. shews the way in which the
Schools were affected with Diphtheria. The highest incidence was