DIPHTHERIA IN THE CITY

Dominion, Volume 10, Issue 3167, 18 August 1917, Page 8

DIPHTHERIA IN THE CITY

A SERIOUS OUTBREAK FIFTY-ONE CASES IN FOUR WEEKS THE "CONTACT" DIFFICULTY No less than S3 cases of diphtheria were notified in the Wellington Hospital District during- tho four weeks ended August 14. Of these 51 were from. AVellington City. These figures are alarming. With a view to stamping out this scourge, people should realise this and guard against infection ns far as lies in their power. The report of the inspectors for the month ended August 11 for the Wellington Hospital District (which extends up to Tokomaru on the west coast and to the Rimutakas in tho other direction), discloses the following state of epidemic disease: —

No. cases. Scarlet fever 18 Diphtheria 83 Enteric 1 Tuberculosis 8 Blood-poisoning , 3 Cerebrb-spinal meningitis ] The reports for Wellington City show 'the ramifications of diphtheria as follows :— District. Cases. Newtown 11 Mount Victoria 2 Wallace Street 2 Te Aro Flat 5 Kelburn 1 Thorndon 5 Berhaninore Island Bay 2 Maranui 2 Roseneath 1 Kilbirnie 3 Brooklyn 3 Mitchelltown 3 Taitville 2 'Aro Street 2 Basin Reserve 3 Vogeltown 5 Happy Valley 1 Two Patients in One Bed. Of the eleven c.ißes reported in Newtown, five were contracted in the Wellington Hospital, which furnishes rather a striking indication that the accommodation for Che treatment of diphtheria patients is deficient at the Hospital, and that the policy of the board in making a. diphtheric ward an urgent matter is a wise one. The conditions have been so bad at times, it is stated, that two diphtheria, patients have had to be accommodated in one bed. When the place is'so congested as to demand Kuch measures it can hardly surprise anyone to hear of members of the staff contracting the disease, as has been the case. Diphthoria Everywhere. Is showing the range of the epidemic in our own district the following figures for the month ended August 14 will be read with interest:— Number Locality. of cases. Wellington City 51 Muritai 5 Rbna Bay 1 Petono 1 ' Lower Hutt 6 Trontham 3 Silverstreani 1 Ngaio 2 Porirua 2 Reikornngi 2 Levin 2 Shannon 2 Heatherlie 4 Tokomaru ■.. 2 Total 83 The Wellington district is not by any means the most severely visited by diphtheria., A glance at the Public Health Department's bulletins for the past few weeks shows that the North Canterbury district (which it includes) is even suffering more than Wellington. The extent of tho progress of tho disease in tho four centres may be fairly accurately judged from the following figures (the different lines being the returns for the weoks ened July 16, 23, 30, August 6 and 13):-

K. CanWellington, terbury. Otago. Auckland. ■ 28 38 — 11 . 13 17 2 13 10 30 3 17 19 21- 1 15 13 21 2 9 Fighting the Disease. Diphtheria is a hardy enemy. Its organism is well known, and 'bacteriologists know its habits, length of life, etc. Next to anthrax, it is accounted one of the hardiest of those organisms that exist to attack the human species. Under the mioroscopo the active or positive bacilli resembles a tiny dumbbell, each bell, so to speak, being black in colour, and joined together by a gelatinous ligament. Its home is the throat, where it thrives on the warmth and moisture, creating in its development a kind of fungus that if not treated is likely to choke the patient. Fortunately an antitoxin has been discovered which, when properly administered in good time, ie an absolute specific. Yet well known bs the organism ie. it is one of the most difficult to eradicate, once it has obtained a hold on a oommunity. It is smpposed to be at its liveliest after a period of drought (and our last summer was a very extended and extraordinarily dry one), and yet it can live throuieh a fitark Russian winter unharmed. Diphtheria is one of those diseases which reply uipon "carriers"—persons 'n whom the disease may not develop—who may distribute the harmful organism, without knowing it. unless liis or her throat is "swabbed" and the virulent organisms are discovered. Then, having discovered the "carrier," what is to. be done with him? He is a thoroughly healthy man, perhaps, without a trace of disease iiiprm him—is he to be made a prisoner for the rest of his days?

Control of Contacts. Dr. Watt, tho District Health Officer, who attended a meeting of the Hospital Commitele on Thursday, stated that the question of tho control of contacts bristled with difficulty. The members of fhe board were inclined to think that the control of contacts -was altogether too lax, ami that thp disease was thus permitted to spread. Dr. Watt pointed out that tho control of contacts was a verv iinnortnnt matter, but how was it to be effected? Suppose tho child of a working man was taken away to the Hospital with the disease, was that man, after his clothes and the house were fuuiisjnted. to be forced to remain isolated for a week or a fortnight? and. if so, who was going to provide for his wife and family during the period of isolation? Tt was conceded by some that isolation under suoh cases was well niirh impossible, though it might be in the interests of public health. Another point raised was an alleged laxity in advising school headmasters of cases, and impressing on tliPni their duty of excludini contacts from attendance. In regard to children, it "'.is perhaps advisable that a Strict isolation should be insisted upon, l'or it was futile to keep contacts away from school and yet allow them to play about, the streets whilst excluded from the school premises. Some parents, too, unconsciously become dangerous contacts j they will nurse the ailing chiM up to the' last moment, t.akine an altogether unnecessary risk or being placed in a position to infect others. II is tho duty of the health insiipctors to locate cases, fumigate premises, instruct, householders. "«« •'"I™ 0 mml teachers, nflcr which it is for those people (o help the authorities all they can. One inspector recently was threatened with physical -nolence on advising a father not to kiss hi* cr-'ld. wlu. wus being taken away to the Hospital! School Precautions. When an inspector sonds in a form intimating a case lo a head teacher, he nlso supplies a copy of the following instructions:— . , "Children suffering from this infectious disease to bo excluded from school— "(1) If the case treated at home, until a medical certificate (preferably one based

upon bacteriological examination) is furnished:

"(2) Until a fortnight after date of discharge from hospital. "Children living in houses where 'this infectious disease exists, or otherwise exposed to infection, to be excluded from school—

"(1) If the case treated at home, until disinfection of house has been carried out:

"(•2) If caso removed to hospital, until seven day* after date of removal. "•Note.—A certificate must in either case ba presented by child that house, etc., has been disinfected."