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49
The table shows that since 1910, diphtheria has prevailed
more in Woolwich parish than in the rest of the Borough.
Last year Eltham suffered more than it has done hitherto.
Since the year 1908, diphtheria has been particulary prevalent
in the south-east of London, specially in Greenwich,
Lewisham, and Woolwich. This disease shows a tendency
to be endemic in certain localities for a series of years.
48. 392 cases, or 94 per cent. of total notifications, were
removed to hospital, oompared with 81, 92, 81, and 93, per
cent. in the four preceding years. A certificate of efficient
home isolation was given in 7 cases, oompared with 1, 1, 3,
12, and 1, in the five preoeding yeare.
The case mortality was 9.7 per cent., compared with 10 4,
3.4, 5.4, 5.2, and 7.0 in the five preceding years.
Many of the cases were very mild, and in several cases
there were no throat symptoms, but discharge or soreness
of the nose. Such cases rarely have medical attendance,
and would escape detection if other cases in the family on
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.
Nine carrier cases, with or without slight symptoms, were
discovered by your Medical Officer of Health. The usual
steps were taken—school absentees were visited and medical
attention obtained; children in affected classes were medically
and bacteriologically examined, as were also a large number
of contacts and suspected cases, and all cases found to be
infectious strictly isolated.