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He infected his sister, brother, and six school-fellows, and cases
continued to occur in connection with the school until the
Christmas holidays. An examination was made of all children in
affected classes, and suspicious cases were examined bacteriologically.
All absentees for sore throat were visited at their homes,
and in this way some cases of diphtheria were found and the
outbreak limited in its spread.
The holidays were extended for two weeks and the outbreak
finally ceased.
58. Bacteriological Diagnosis.—679 swabs were sent to the
Lister Institute to be examined for the presence of diphtheria
bacillus. In 128 the true Klebs Loffler bacillus was found (in 6
of these, Hoffman's Bacillus co-existed with the Klebs Loffler
bacillus); in 171 Hoffman's Bacillus was found, and 380 were
found free from either the Klebs Loffler bacillus or Hoffman's.
Of the 679 swabs examined, 175 were taken from school children
by myself. Of these 26 contained the true Klebs Loffler bacillus,
and 67 Hoffman's bacillus. Most of these were contacts seen about
10 days after notification of the primary case, for the purpose of
giving certificates to enable pupils to return to County Council
Schools. Others were examined with the object of finding possible
sources of infection, e.g. where the first case notified in a house
was a child not attending school.
Of the 175, 148 had no noteworthy abnormal symptoms, while
27 had symptoms, viz., 6 had tonsilitis, 9 congestion or exudation
of fauces, 1 clinical diphtheria, and 13 some form of rhinitis. Of
the 27 cases which had symptoms, 7, or 26 per cent., were positive,
while of the 148 cases with no noteworthy symptoms, only 19, or
13 per cent., gave positive results.
Of 4 cases with purulent discharge, encrustation and soreness
of the nostrils, 2 gave a positive result, 1 shewed Hoffman's
bacillus, and 1 was negative.