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of the second case (21 days after the first) the Hospital was visited
and the Cook was found to have suffered from a sore throat which
proved to be streptococcal. Pending the result of a swab she was
suspended from duty. On the occurrence of the third case 11 days
later all the patients and staff were swabbed and of 34 swabs 16 showed
streptococci to be present. These 16 cases, and the 3 cases in the
Isolation Hospital, were re-swabbed and the swabs were sent to
Dr. F. Griffith, who had kindly offered to type them at the Ministry
of Health's laboratory.
Prophylactic doses of Scarlet Fever Antitoxin were given to
15 of the patients on 8th October and Dick testing was attempted
on the 10th, but the results were probably vitiated by the antitoxin
given two days before.
Case 4 occurred seven days after Case 3 and this again proved
to be a Type 2 infection. Case 5 was notified on 8th December
(23 days after Case 4) and Cases 6, 7, 8 and 9 on the 9th, 11th, 12th.
and 17th December respectively, all these cases, except the last,
being again Type 2 infections.
Following the notification of the cases on and after 8th
December, the nursing and domestic staffs were re-sw'abbed and the
swabs were again typed by Dr. Griffith, who found that two of the
Nurses were carrying Type 2 scarlatinal haemolytic streptococci.
These Nurses were suspended from duty until, after local treatment,
they had given negative swabs. One of the Nurses later proved to
be a persistent carrier.
Nothing further occurred until the 13th January, 1932, when a
new case of an indefinite type was notified, and this was followed
by a Type 2 case on 4th February and an indefinite type case on
8th February. The nursing and domestic staff were again swabbed
for typing by Dr. Griffith on each occasion ; on the first, both Nurses
were again carrying Type 2 streptococci, and on the second occasion
one of the Nurses only (i.e., the one who had proved a persistent
carrier during 1931). Both were suspended for as long as necessary,
while later the persistent carrier was sent away for three weeks'
holiday and, proving to be still a carrier, she has recently had
tonsillectomy performed with the termination of the carrier state.
(C) DIPHTHERIA.
The incidence of Diphtheria showed a welcome decrease from
509 cases during 1930 to 324 during 1931. The weekly incidence was
at an average rate of 6.62 cases with a maximum of 17 for the week
ending 18th July.
The monthly incidence by Wards was as follows:—
The monthly incidence is given in the following table:—