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43
in 78 (189 in 1909) Hoffman's bacillus was found, and 368
were found free from either the Klebs Loffler bacillus or
Hoffman's.
Of the 526 swabs examined, 157 were taken from school
children by myself. Of these, 21 contained the true Klebs
Loffler bacillus, and 43 Hoffman's bacillus. Most of these
were contacts seen about ten days after notification of the
primary case, for the purpose of giving certificates to
enable pupils to return to London 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 157 contacts swabbed by the Medical Officer of
Health, 19 had symptoms, viz., some form of rhinitis.
Of these, 5 gave a positive result, 2 showed Hoffman's
bacillus, and 12 were negative.
The contacts found positive on the first examination who
had no symptoms were re-examined at intervals of ten
days; 3 were found negative on the second examination;
in 3 Hoffman's bacillus was found on the second examination,
in 4 a positive result occurred twice. Two negative results
are usually obtained before certifying the patient free from
infection, and Hoffman's is treated as a negative unless in
special circumstances, as after a positive result. In one
case Diphtheria bacilli persisted for three examinations, and
was succeeded by Hoffman's, and a recurrence of positive,
viz., + + + H (+ H) -H.
Positive cases with any symptoms were notified and sent to
hospital, or strictly isolated; positive cases without any
symptoms were excluded from school and from mixing with
other children outside the house.