22,6 Gomez and Navarro: Diphtheria Carriers 565 



examination, in 1919 (in one instance the bacilli were virulent), 

 and there were children susceptible to diphtheria as shown by 

 results of the performance of the Schick's test. In this institu- 

 tion we have data of the constant existence of carriers, in spite 

 of the isolation of those detected previously. Two years later 

 another examination was made of the inmates of the orphanage. 

 From 217 inmates (most of whom had been examined two years 

 previously) 9 pure cultures were isolated, all of which proved 

 to be nonvirulent in the animal tests ; also, one of the positive 

 carriers (G.C.) was found to have harbored the bacilli two years 

 previously. 



We see from the above that, in spite of association with 

 clinical cases and with persons harboring diphtheria bacilli, 

 the disease has not spread in a school (Santa Clara) with a 

 daily attendance of about one thousand. In an institution 

 (Philippine Government Orphanage) where there is more or 

 less intimate association among the children, and where there 

 were always carriers and persons susceptible to the disease, clin- 

 ical diphtheria has never been known to develop in the five years 

 of its existence. In another institution, Bilibid Prison, no diph- 

 theria has been known to occur for some years before these 

 carrier examinations were made, in spite of the existence of 

 carriers of avirulent and of virulent diphtheria. It is the 

 present consensus that diphtheria bacilli which are found by 

 laboratory test to be nonvirulent are not harmful to human 

 beings, and healthy persons harboring nonvirulent bacilli need 

 not be isolated. This criterion has been recently confirmed 

 experimentally by inoculation of the throats of human bemgs 

 with virulent and with nonvirulent diphtheria bacilli by Gutnne, 

 Marshall, and Moss. 4 



SUMMARY 



1. At least a certain percentage (2.08) of healthy individuals 

 in the Philippine Islands harbor diphtheria bacilli in their 



th 2° a The diphtheria bacilli harbored in healthy persons have 

 been found nonvirulent in about 89 per cent, and virulent in 

 about 11 per cent of the carriers. 



Johns Hopkins Hosp. Bull. 32 (1921) 369. 



