London's Pulse: Medical Officer of Health reports 1848-1972

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Wimbledon 1909

[Report of the Medical Officer of Health for Wimbledon]

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1908) since the year 1891. The attack rates in the various
Wards were as follows:—
Dundonald .98
St. John's .87
St. Mary's .97
Cottenham Park .92
South Park 2.27
Trinity 2.30
The 90 cases occurred in 79 houses, in one of which there
were 3 cases, and in ten others 2 each.
In Diphtheria, as in Scarlet Fever, the trouble from a
public health point of view is not with the serious cases, but
with the mild ones, which are overlooked and act as centres of
infection, and in addition to those that are known as .carrier
cases which may harbour virulent Diphtheria bacilli for
extended periods, without suffering from the clinical manifestations
of the disease. Another point which gives rise to trouble in
administering the Public Health Department with regard to
Diphtheria is that with a simple acute Tonsilitis, as a rule, the
febrile symptoms are much more marked than in Diphtheria,
so that given a suspicious throat with a temperature of 103.5
or over, it is odds on that being simple acute Tonsilitis, and not
Diphtheria, whereas with the same conditions and a temperature
of 101 or less, or even normal, it is very often found to be true
Diphtheria, so that the public are apt to pay little attention
to what seems to them at first sight a far less serious condition
than that produced by an acute Tonsilitis' At the same time
there are a large number of cases whose identity can only be
cleared up by a bacteriological examination, and it is often not
sufficient to rely on one negative swab as clearing up the
diagnosis, as is very well illustrated in the case recorded in the
previous paragraph under the heading of Scarlet Fever.
At the same time it is of the utmost importance that no
case should be allowed to go free until it has been bacteriologically
proved free from infection, as it is so often found that
these cases harbour the virulent form of the bacilli, which can
be actually demonstrated to be fatal to guinea pigs for very
long periods'
The importance of this is emphasised in the memorandum
on .exclusion of children from school. in the following
words:—
.The examination of the throats of .contacts'
whenever practicable, by bacteriological means, is a most
important aid to precautionary measures against the
spread of diphtheria. If a positive result is obtained
in the case of children showing no evidence of diphtheria,
the presence of some measure of infection must
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