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33
The return case well illustrates the difficulty in certain
cases. A.D. returned from hospital after two months'
isolation 24/12/14. Another case occurring at his home, he
was swabbed and found negative. A third case occurring, he
was again swabbed 1/3/15, and found positive. He had
otorrhœa and rhinorrhœa, and was sent back to hospital,
whence he was finally discharged in July, after 6½ months in
hospital.
44. Bacteriological Diagnosis. Since January, 1913, the
Council's bacteriological work has been done by the Bacteriological
Department of the Seamen's Hospital, Greenwich.
776 (915 in 1914) swabs were examined for the presence of
diphtheria bacilli. In 84 (95 in 1914) the true Klebs Loffler
bacillus was found, in 54 (47 in 1914) Hoffman's bacillus
was found, and 638 were found free from either the Klebs
Loffler bacillus or Hoffman's.
Of the 776 swabs examined, 168 were taken from school
children by the Medical Officer of Health. Of these, 12
contained the true Klebs Loffler bacillus (so-called positive
cases), and 16 Hoffman's bacillus. Most of the children were
contacts seen about ten days after notification of a primary
case for the purpose of preventing pupils returning to school
in an infectious state. 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;
others, again, were children suspected to have diphtheria by
the School Teacher, the Attendance Officer or Sanitary Inspector.
Eight positive cases had some symptoms, viz. : running
or sore nose, mild clinical diphtheria or follicular tonsilitis.
These were notified and sent to Hospital or strictly isolated.
Positive cases without any symptoms were excluded from
C