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37
attack; her mother could not afford medical attendance, and
for fear of the attendance officer sent her to school before she
was well.
Elizabeth Street school was also specially affected at the
close of the year.
56. Bacteriological Diagnosis.— 828 swabs were sent to the
Lister Institute to be examined for the presence of diphtheria
bacillus. In 123 the true Klebs Loffler bacillus was found (in
15 of these, Hoffman's bacillus co-existed with the Klebs
Loffler bacillus); in 278 Hoffman's bacillus was found, and 427
were found free from either the Klebs Loffler bacillus or
Hoffman's. The increase of cases having Hoffman's bacillus is
noteworthy.
Of the 828 swabs examined, 341 were taken from school
children by myself. Of these 25 contained the true Klebs
Loffler bacillus (including 9 with Klebs Loffler and Hoffman's),
and 167 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 341, 28 had symptoms, viz., 3 tonsilitis, 4 congestion
or exudation of fauces, 2 clinical diphtheria, 18 some form of
rhinitis, and 1 enlarged cervical glands. Of the positive cases,
32 per cent. had symptoms; of Hoffman cases, 7 per cent,
and of negative cases, 8 per cent, had symptoms.
Of 7 cases with purulent discharge, encrustation and soreness
of the nostrils, 4 gave a positive result, 1 showed
Hoffman's bacillus, and 3 were negative.