Annual report of the Medical Officer of Health 1910 / Wimbledon Borough Council.

  • Wimbledon (London, England). Borough Council.
Date:
[1911]
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: Annual report of the Medical Officer of Health 1910 / Wimbledon Borough Council. Source: Wellcome Collection.

    13/196 (page 11)
    During the year much more use has been made by the practitioners in the district of the bacteriological diagnosis, particularly in respect to contacts, and in several cases it has been found that those in close association with the patient have been harbouring the Diphtheria (Kdebs Loeffler) Bacilli in their throats, and these cases have been temporarily isolated, and, as a rule, a very short time under antiseptic treatment has been sufficient to eradicate the bacilli. It is, ox course, in the majority of cases impossible to say whether the infection has come from the patient to the “ carrier ” or from the “ carrier ” to the patient, and although these cases are not suffering from Diphtheria themselves, the fact that they are harbouring the Diphtheria Bacilli causes us to regard them as having some measure of infection. Two striking cases occurred in large houses, one of a rental of about £90 per annum and the other about ,£300 per annum. In one case sore throats presenting no clinical appearances of Diphtheria had been running through the house; the drains had been thoroughly examined and found perfect. On the occurrence of the next case, which was the children’s nurse, a swab was taken and Klebs Loeffler Bacilli found. The whole household were swabbed, and one of the children and a fellow maid of the patient were found to be harbouring the Klebs Loeffler Bacilli. In the other case, Avliere the household consisted of two parents, two sons, a governess, and six maids, the mother and governess were found to be harbouring Klebs Loeffler Bacilli, the patient being the youngest boy. During the year eight infectious ‘‘carriers” and two definite cases of Diphtheria were discovered as the result of swabbing. The importance of the bacteriological diagnosis is best seen by quoting from a standard work on infectious diseases, which states : — t( It must be observed at the outset that certain very mild cases of Diphtheria cannot be distinguished by clinical observations from simple inflammation and ulceration of the tonsils. We have already stated, and we must again draw attention to the fact that Diph¬ theria may occur without the formation of membrane; indeed, in some cases there is no exudation whatever. Such cases are to be diagnosed only by means of a bac¬ teriological examination, by a history of specific con¬ tagion, or by subsequent paralysis. On the other hand, it must be remembered that the membranous exudation may result from other causes than Diph¬ theria. We have already described such a condition as met with in Scarlet Lever. It may occur quite inde¬ pendently from this disease; and such cases are to be