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37
theria. The percentage of the three preceding years was 7, 14,
and 8 respectively.
55. Source of Infection. In 74 cases, a probable source of
infection was noted, viz., in 41, other inmates of the house were
suspected to be the source; in 14, school-mates; 9, neighbours
and friends; 4, return cases; 1, travelling; 2, general hospitals
(out-patients' departments); and in 3, other surces.
E.D., found to have a sore nostril, but not to have been otherwise
unwell was bacteriologically examined and the diphtheria
bacillus found. He was sent to hospital, but not before he had
infected a sister and three neighbours. He was kept at hospital
three months before he was free from infection.
On inquiring at a house where two cases of diphtheria had
occurred a boy living next door was found to have a sore nostril;
he also had diphtheria bacilli and was sent to hospital. These
cases show how infection is carried, and demonstrate the advantage
of examining bacteriologically all children in houses where
diphtheria has occurred, before their return to school.
56. School Infection. Since the practice just referred to has
been carried out, school infection has been decidedly less prevalent.
There was, however, a well-marked outbreak, or rather two outbreaks
last year at Bostall Lane school. 26 cases occurred from
September to December. In the beginning of September a young
man died of laryngitis, which was probably diphtheritic, but the
true nature of his disease was not suspected till afterwards. A
child in the same house attended school for three days with a
running at the nose before she was notified as having diphtheria.
Within ten days of her ceasing attendance six other children
began with diphtheria. Six further cases occurred up to the end
of November. Then a similar occurrence took place, a boy with
nasal discharge attended school five days before being notified.