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6
London is becoming the subject of anxious consideration. Attention
was called to it in last year's Annual Report. Since the
earliest appearance of Diphtheria little more than thirty years ago,
every annual return, with few exceptions, exhibits a larger number
of cases than its predecessor. And the year of this Report does
not furnish an exception to that which apparently has become an
established rule. On the contrary, the percentage of increase is
greater than on any previous occasion. Formerly Diphtheria
showed a preference in its incidence for small villages or isolated
country houses, especially when situated upon the banks of
streams, in the shed of rivers, or in low-lying and marshy districts.
The atmosphere of large towns was regarded as exercising a
prejudicial influence upon the developement of the poison. Anything
more than a feeble and occasional outbreak in the Metropolis
was neither anticipated nor feared. But unfortunately experience
now points to the possibility of its acclimatization, and in the
Parish of I ambeth its distribution has not been affected by the
altitude of the soil. By a reference to the map, which indicates
the position of the affected houses, it may be observed that a local
outbreak occurred in the neighbourhood of Lyham Road, Brixton
Hill; the Board School there situated, bearing a conspicuous part
in the dissemination of the contagion. As much care was
exercised in the exclusion of children from attendance at school,
when belonging to the family of an infected person ; the extreme
measure of closing the school was not considered necessary.
This decision was justified by subsequent events. No further
cases among the children in attendance occurred after a notice of
the existence of the outbreak was communicated to the Sanitary
Office, and the necessary precautions had been acjvised and taken.
The Notification of Infectious Disease Act, which came into operation
on the 31st October, in the year of this Report, by securing
an early intimation to the Authorities, leading to the
prompt isolation of infectious persons will it may be anticipated
have considerable effect in checking the extension of outbreaks
such as the one to which reference is made. Although Diphtheria