View report page

23
it at all necessary. It is agreed upon by all competent authorities
that during Diphtheria prevalence, there often exists a large number
of mild and unrecognised cases of Throat Disease, which are highly
infectious and competent to spread the disease amongst the healthy.
It is not unknown for those, who dispute the importance of school
influence in the spread of Diphtheria, to deny the existence of such
mild cases as those alluded to, but the matter has been established
beyond all power of denial.
To illustrate what I mean by unrecognised cases, I would refer
to an attack of Diphtheria which occurred in a workshop in Hackney
amongst a number of girls. Two or three of the girls were away
suffering from Diphtheria; and in order to ascertain the full extent
of the disease, I suggested to the Manager of the establishment, that
the throats of the remaining girls in the workshop should be medically
examined. This was done, and it was then ascertained that 19
others were suffering either from inflamed or ulcerated throats,
Such unrecognised cases may, I have no doubt, be found in every
outbreak of Diphtheria, and I am convinced were active in the
Daubeney Eoad prevalence.
Again, whilst making enquires at the school as to the cause of
this outbreak, I learned that several scholars where absent. On
enquiry at the homes of these children, it was ascertained that
several were suffering from sore throat, and ulcerated throat; one
or two of these were afterwards notified as Diphtheria.
Having carefully considered the whole of the circumstances
connected with the outbreak amongst the scholars at Daubeney Eoad
Board Schools, I am of opinion that the disease was spread chiefly
by personal infection at School, especially in the infants' department,
the infection being conveyed largely by means of unrecognised cases ;
for no doubt the Head Master and Mistress excluded any cases
immediately they were recognized as Diphtheria. How the disease
was introduced it is impossible to say; probably by an ill-defined
case, or by some secondary case from an infected household.
Whilst considering what measures might be adopted to prevent
a recurrence of such an outbreak, the fact must not be lost sight of,