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Board have given in a general school-room, 10 square feet of floor space per scholar, and the height was
ordered to be 13 feet, making 130 cubic feet." Assuming that a child requires 1,500 cubic feet of air
per hour, half the amount that is said to be required for an adult, to keep down the carbonic acid
impurity to permissible limits, he points out that the atmosphere would be required to be changed
eleven times, and that in temperate climates and under ordinary circumstances more than three changes
per hour produce cold currents of air and draughts.
Wandsworth (Clapham).—The number of cases notified in each month is stated, and the medical
officer of health writes—"This shows a gradual increase from the beginning of the year to a
maximum in September and October, checked only by a slight fall in August, associated probably
with the school holidays."
(Wandsworth).—The report of the medical officer of health contains an interesting account of
two outbreaks of diphtheria in that parish. In October and November, 1896, there had been an
outbreak of diphtheria among the children attending the National school in Roehampton.
In January, 1897, of 8 cases, 5 occurred in one family, and one of these children attended the
Roehampton School, while the other 4 attended a Board school in Ward I. of Wandsworth parish.
In February and March, 20 and 17 cases occurred respectively in this parish. In 23 households
invaded, the first sufferer in 9 instances was an attendant at this Board school, and in 13 instances
an attendant at a National school in the same ward, and in 2 instances the children infected had
not been to any school. The distribution of the affected children in the different departments of the
two schools is stated. Children in all departments appear to have been affected, and often considerable
intervals occurred between successive cases. Later, children who attended a Sunday school but not a day
school, were found to be affected; this school was held in the National school buildings. The conclusion
arrived at was that the National school, and not the Board school, was responsible for the disease,
and was closed for 14 days, "with the almost immediate effect of checking the outbreak." The medical
officer of health adds," the fact that the outbreak was checked by the closure of the school affords strong
grounds for the belief that, at any rate in the later cases, the infection was received at school, principally
at Sunday school, where the same control is not possible as far as overcrowding is concerned."
The second outbreak was limited to children attending one school in No. 3 Ward, and the infection
was traced to the attendance at school of a child suffering from the disease on the afternoon of March
2nd. As many as 31 cases occurred and 13 deaths resulted. The school was closed on the 8th March
for 21 days, and after that date 13 cases were notified, 4 of which were in houses previously infected.
Woolwich.—The medical officer of health publishes a table showing that in successive years
from 1892 to 1897 the number of cases of diphtheria notified were, respectively, 17, 24, 49, 67, 99 and
150. He states that "the most careful investigation has been made with the view of determining the
cause of the increased prevalence of diphtheria, but with no satisfactory result. In no single instance
could any possibility of infection at school be found."
Lewisham.—The medical officer of health reports that "a large number of the cases in Lewisham
occurred in the early part of the year, and were part of the epidemic which occurred in the later
months of the year." This epidemic it will be recollected was shown by Dr. Hamer to be due to
infection of children in a Board and a National school.
The medical officer of health writes, "I had occasion to order the fumigation of two Board
schools in the district during 1897. This was done with the consent of Dr. Smith, the medical officer
of the School Board, and in each case there were no fresh cases of diphtheria notified after the fumigation
had taken place."
Plumstead.—The medical officer of health writes, "the Slade school was most affected, and
after it Burrage-grove, High-street and Ancona-road. No cases occurred at Eglinton-road schools,
and only three at Bloomfield-road."
For the purpose of ascertaining whether, as in previous years, there was decrease of diphtheria
prevalence among children of school ages during the summer holiday, Diagram XI. has been prepared.
The summer holiday of the schools of the London School Board began at noon on Thursday, 22nd
July, or the latter part of the 29th week, and the schools re-opened on Monday the 23rd August, or
the beginning of the 34th week. The diagram shows a marked fall in the number of notified cases
at ages 3-13, extending over the 31st-34th weeks; there is also a noticeable decline in the number of
notified cases, at ages 0-3 and 13 and upwards, but this decline is later than and does not
correspond in point of time with, the decline shown at ages 3-13.
If the number of cases in the four weeks most subject to the influence of the holidays be
compared with numbers during the four weeks preceding and subsequent to the holidays, the following
results are obtained for the three age-periods mentioned—