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34
school and from mixing with other children outside the house.
Of the 168 cases, 47 had some symptoms.
During 1915 it was for purposes of economy decided not
to swab all the contacts coming for examination, but only
those showing some abnormal condition, and those who, for
any reason, were specially likely to be carriers ; but all were
carefully examined as to the presence of any pharyngitis,
rhinorrhœa or other symptoms.
Unfortunately it has been found by experience that a
negative bacteriological result is no guarantee that a contact
will not within a few days or weeks develop diphtheria. One
examination, too, is insufficient, and where rhinorrhcea or
special suspicion exists, a second swab is taken if the first is
negative or shows Hoffman's bacillus. In two cases last year
this practice led to the discovery of carriers.
One contact was brought to me with marked symptoms of
clinical diphtheria, but the mother stated that she had made
no complaint and she had observed nothing wrong with her.
Diphtheria antitoxin is kept at the Town Hall and the
Plumstead and Eltham Free Libraries and supplied to medical
practitioners on application at cost price, or free where there
is inability to pay. Last year 18 quantities were supplied on
payment and 7 gratis.
ENTERIC FEVER.
45. There were 23 cases of enteric fever, not including 8
cases of mistaken diagnosis notified as enteric. The caserate
was 0.17, compared with 0.15, 0 06 and 0 09 in the three
preceding years. For the ten years 1892-1901 the rate never
fell below 0.41. The case-rate in London was 014.
46. There were 5 deaths from this disease, giving a deathrate
of 0.04. The death-rate in London was 0.03.