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78
diphtheria.—The prevalence of Diphtheria in the
Borough still remains high. The admissions in 1925 were
719, which is the largest number for the past five years. The
majority of the cases, however, were of a mild type as shown
by the total deaths which numbered 18, the lowest figure yet
recorded. During the year a large number of swabs were
examined for the practitioners in the Borough, but it is
impossible to estimate to what extent, if at all, the practice
of routine throat swabbing has affected the mortality from
the disease. Unfortunately, bacteriological examination is not
always reliable; a " negative swab " cannot be taken as a
guarantee that any particular case is not suffering from
Diphtheria. This fact was demonstrated by two of the fatal
cases last year. In each of these the swab taken at the
outset by the practitioner was found to be negative, but three
to four days later the true nature of the condition became
obvious from the clinical symptoms, but it was too late then
for antitoxin to have much effect. Early treatment is of such
vital importance in Diphtheria that the mortality would
probably be much reduced of it became a wider practice
among practitioners to give a small injection of antitoxin to
all suspicious cases instead of waitng for the result of a swab.
The total number of cases under treatment during the
year was 880. Of these, 758 were discharged recovered, 18
died, and 104 remained under treatment at the end of the
year.
In 58 cases the larynx and trachea were involved. Of
these, 33 recovered without operation. Tracheotomy was
performed in 25 cases; 6 of these were patients recovering
from Measles, and in 2 cases Whooping Cough was present as
a complication. Seven deaths occurred among the tracheotomy
cases, giving a fatality rate of 28 per cent, of those operated
on. The fatality rate of all the cases admitted was 2.5 per
cent.
The average duration of illness of the fatal cases prior
to admission was 4 days, and the average age was 3½ years.
The amount of antitoxin given to the fatal cases averaged
62,000 units, while the average amount for all the cases was
15,000 units. The duration of residence of all the Diphtheria
cases averaged 54.34 days.