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children are examined and "swabs" taken from the nose and
throat of all suspicious cases. Disinfection of slates, pencils,
class rooms, etc., being done where thought necessary.
In addition to the above, a weekly list of infected premises
is sent to the Schools, Public Libraries, Pawnbrokers, etc.
Free bacteriological diagnosis of all doubtful or suspected
cases is also given by the Council to all Medical Practitioners.
The use of Antitoxine as a prophylactic has not been
recommended, I doubt its value in mere "carrier cases," where
there are no symptoms, for the serum is simply Antitoxic, it is
not anti-bactericidal.
Summary and Conclusions.
1. Table I. shows the great variation which occurs in the
prevalence of Diphtheria in the course of a number of years,
and suggests that considerable caution should be exercised
before either assuming that Diphtheria is excessively prevalent
in a district, or conversely, before attributing undue value to
our efforts of prevention.
2. Tables II. and III. indicate that Diphtheria is more prevalent
in the Urban Districts of Essex than in England and Walt s
as a whole, also, although Diphtheria has for some years been
rather prevalent in East Ham, the notification rate and
death rate from the disease compares not unfavourably with
other similar populous districts in the County.
3. The various preventive measures now in force in the
Borough comprise all that the most advanced Public Health
Authorities can well undertake, in fact, I doubt if any other
Authority does more to check the spread of this disease than is
now being done in your Borough.
ENTERIC FEVER.
The steady decrease in the prevalence of this disease, which
has been mentioned in the Annual Reports for the last four
years, still continues. During the past year only 10 cases were
notified, this is the lowest number reported in any year since
notification was established 20 years ago.