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reported as follows "They are both, I am given to understand, of
very severe character, and there is nothing very definite to show how
they originated; but the sanitary condition ot the premises in which
they occurred is far from satisfactory, and I fear that if the disease
gets a footing in this block of cottages we shall experience great
difficulty in stamping it out. The back premises of all these houses
are very insanitary, there is no paving in the back yards, which are
in a sodden condition and present exactly those conditions which
would harbour infection very tenaciously.
The premises themselves are far from clean, and I am of opinion
that notice should be served to thoroughly cleanse and disinfect all
the premises, for which purpose every room should be scraped,
fumigated and lime-washed. The soil of the back yards should be
deeply dug, disinfected and cemented, and this course I should advise
with regard to the rest of the cottages in this group, and others which
are in a similar condition in the same street." Proceedings were
ultimately taken under the Housing of the Working Classes Act, and
a closing order obtained. Since then there has been no recurrence
of Diphtheria in Clarence Street.
(2) The second group of five cases occurred in separate houses
on the Hambro Estate. Four cases occurred between the 4th and
11th of July. All these obtained their milk from the same Vendor.
The fifth case occurred on July 20th, and in this instance condensed
milk only was used.
All the cases in this group were of a severe character, and it was
feared that we might have to deal with a considerable outbreak of the
disease. As the result of measures taken, which it is not expedient
to particularise here, the outbreak was nipped in the bud, and no
further case was notified on the North side, with the exception of one
at the end of December. (3) The third group of seven cases occured
on the South side between July 29th and December 13th. Two were
cases of Membranous Croup, and of the five cases of Diphtheria, one
patient was a visitor to the district, and had symptons of the disease
when he arrived here; a second case was of a doubtful character, the
bacterial test proving negative, and as regards the remaining three,
occuring September 24th, October 16th and December 6th
respectively, the only factor in common was then that they were
scholars at the same school.
As in Scarlet Fever, one of the principal factors concerned in the
spread of Diphtheria is the presence of mild unrecognised cases which
do not come under medical observation at all, and so escape isolation.
There is not, however, the same difficulty in the diagnosis of mild
Diphtheria as in Scarlet Fever. By means of the Bacterial test it is
possible to prove the presence or absence of Diphtheria in a given
case. The Council afford facilities for this test to be carried out free
of charge to the Medical practitioners in the District.