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38
medical attendance, and would escape "detection if—other
cases in the family or school did not lead to a search for the
source of infection. The search for, and detection of, these
nasal cases is one of the most important duties of the Public
Health Department.
In the second half of the year there was a widespread
outbreak of a very mild form of this disease. At first the cases
were specially associated with Wood Street and St. Mary's
Schools, as in 1911, but later on the disease prevailed in all
parts of Woolwich and Plumstead, and several cases occurred
at Goldie Leigh. In addition to the notified cases (many of
which never complained of illness), 66 cases (of which 37
. occurred from August to December) were found to be carriers
of the infection in their throat or nose without having any
symptoms. 59 carrier cases with or without slight symptoms
were discovered by your Medical Officer of Health from
August to December. The usual active steps were taken—
school absentees were visited and medical attention obtained;
children in affected classes were medically and bacteriolo;
gically examined, as were also a large number of contacts
and suspected cases, and all cases found to be infectious
strictly isolated. Printed precautions against diphtheria
were, as in 1911, distributed all over the Borough by the
agency of school children (see Annual Report, 1911). The
very mildness of the affection made it increasingly difficult
to detect the cases, and so remove the sources of infection.
50. The following table gives details as to cases notified,
cases bacteriologically examined, and deaths in each of the five
later months of the year. The large number of cases with
Klebs Loffler bacillus but no symptoms, and the small number
with Hoffman's bacillus, is noteworthy.