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18
of April, May arid June. The boys infected were kept well isolated,
and a most rigid examination was enforced each morning
by the doctor in attendance, to whose energy and foresight it
was chiefly due that the disease was abated. The probability
is that the disease was originated by one of the boys visiting
in the country a house where there was an inmate suffering
from this disease. He, no doubt, got the infection in his
clothes or throat and so spread the disease to the other inmates
of the Refuge. The whole of the cases ran a mild course, not
one having a fatal issue.
The drainage of one portion of this Eefuge has since been
entirely relaid, and other works carried out.
At St. James the Less Infant School, Upper Garden Street,
during October and November several cases of Diphtheria
occurred. As an example of how such a disease is spread in a
small way by the aggregation of children at school, I may
mention that the first case occurred in the main room in a boy
who was attacked on October 21st; the second case occurred
in the class-room on October 27th; the third case in the
main room on October 28th in the person of a girl who sat
next the boy referred to. On November 1st the boy who
sat next the girl just mentioned was taken with the disease,
and the girl who sat next this boy was taken with Diphtheria
on November 4th. I may also state that in all these cases,
with the exception of one case, they all lived in different streets
some way distant from each other, and in the one case mentioned
of the two children who lived in the same street, their
houses were some distance apart from each other.
In the United Parishes 20 fatal cases of diphtheria occurred,
compared with 22 in 1897; 126 cases were notified, 43 from
St. Margaret's Parish and 83 from St. John's.
Enteric Fever.—Forty-five cases were notified during the year
and ten deaths occurred, eight of them being cases from the
Guards' Hospital, which were imported by soldiers serving in
the late Soudan Campaign. In one case the origin was
distinctly traced to the patient having eaten some infected
oysters, and in another to contaminated cocoanut water having
been consumed.
Puerperal. Fever.—During the year one death only occurred
from the above disease ; two cases were notified. A letter
was received from the London County Council, dated 5th
December, forwarding copy of a report by their Public Health