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The Measures taken to check the Diphtheria Outbreak of 1901 at Colchester

Published online by Cambridge University Press:  15 May 2009

G. S. Graham-Smith
G. S. Graham-Smith
Affiliation:
[Thesis for the Degree of M.D., University of Cambridge.]
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Finally I wish to draw particular attention to the following facts:—

1. The striking diminution in the case-mortality at the Mile End Hospital which followed the systematic use of antitoxin.

2. The subsidence of the epidemic during the season when diphtheria is commonly most prevalent.

3. The opening of the schools in September without any increase in the prevalence of the disease.

4. The persistence of diphtheria bacilli for long periods in certain of the convalescents and contacts.

5. The success of preventive measures based upon the belief that diphtheria is spread mainly by personal contact, and through the inter-mediation of healthy persons and other who by the means usually employed are not recognised to be suffering from the disease.

Type
Research Article
Information
Journal of Hygiene , Volume 2 , Issue 2 , April 1902 , pp. 170 - 193
Copyright
Copyright © Cambridge University Press 1902

References

page 173 note 1 Eight patients admitted immediately prior to July 16th are included in group II. all of whom had antitoxin previous to admission. The quantity of antitoxin and the date of administration in each of these cases is known to me, and they have been transferred from period I. to period II. in order that a true comparison may be made between the two forms of treatment. Seven others, none of whom died, also received antitoxin before admission, but I have left these in period I. as my information about them is not so exact.

page 173 note 2 Even if sixteen persons, notified to have diphtheria, in whom no diphtheria bacilli were found, be deducted, the case-mortality during this period was only 6·6 per cent.

page 178 note 1 See Journal of Hygiene, Vol. I., no. 2.Google Scholar

page 179 note 1 Between August 14th and 21st swabs were sent to Cambridge for examination.

page 186 note 1 “The result of 950 bacteriological examinations for diphtheria bacilli during an outbreak of diphtheria at Cambridge and Chesterton.” Cobbett, Louis, M.D., F.R.C.S., Journal of Hygiene, Vol. I., p. 258.Google Scholar

page 186 note 2 “Observations on the recurrence of diphtheria at Cambridge in the Spring of 1901.” Cobbett, Louis, M.D., F.R.C.S., Journal of Hygiene, Vol. I., p. 494.Google Scholar

page 187 note 1 At the South-Western Fever Hospital the patient is detained till the bacilli disappear as evidenced by three consecutive daily examinations. Guy’s Hospital Gazette, Vol. xv., p. 294.Google Scholar

The Boston Board of Health, U.S.A., require for hospital patients three consecutive negatives. Paper by Hill, H. W., M.D., Journal of the Massachusetts Association of Boards of Health, vol. VIII., 10 '98.Google Scholar

page 187 note 2 Antiseptic applications, if any were being used, were not applied within the twenty-four hours previous to a swab being taken. If the result of the examination showed that diphtheria bacilli were no longer present treatment was entirely discontinued (unless they occurred on a subsequent occasion) in order that the presence of antiseptics on the swab might not hinder the growth of the organisms on the culture media.

page 187 note 3 One of these suffered from a second well-marked attack of diphtheria and another had been in contact with a recent case immediately previous to examination.