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Diphtheria showed decline in 1905 both in respect of prevalence and fatality. Of the 29 districts
in the county in only five was there excess of diphtheria mortality in 1905 over that of 1904, in almost
all the other districts there was decline. In the eastern districts the death-rates were highest, but
showed an improvement on the rates of the preceding year.
Dr. Kerr states (see Appendix II., page 27), that eight departments were closed (four infants'),
and one girls' class during the year ended March, 1906, on account of the occurrence of diphtheria
among the scholars.
Increased prevalence due to spread of disease through school attendance is mentioned in some
of the reports of medical officers of health. Thus in Poplar it became necessary to close the infant
and girls' departments of the Monteith-road school in the month of July. Prevalence of diphtheria
among the children attending the Mitcham-lane school, Wandsworth; a school in the neighbourhood
of Charlton, Greenwich; and the Church Manorway, Eglinton-road, and Union-street schools,
Woolwich, are referred to. The practice of bacteriological examination of material from children
exposed to infection, and the exclusion of children found to harbour the Klets-Loeffler bacillus was
carried out, but in the case of the Eglinton-road school it became necessary finally to close
the school. Dr. Davies states that this brought the outbreak to an end. Dr. Brown
reports that the plan instituted in Bermondsey of examining all diphtheria contacts among
children before permitting them to return to school has been continued unaltered. Children found
to be harbouring the diphtheria bacillus are excluded from school and the parents are advised
to secure the treatment of the throats of the children. The County Council has recently recognised
the principle that children harbouring the Klebs-Loeffler bacillus should be excluded from school as
possibly infective, and has authorised the Education Committee to refuse during the presence of
diphtheria in any district re-admission to school of children excluded on account of diphtheria or sore
throat until such children shall have obtained a medical certificate of freedom from infection based on
a bacteriological examination.
In connection with the more systematic examination of the throats of children attending school,
Dr. Sidney Davies points out that this has added to the number of notified cases of diphtheria
occurring in Woolwich, cases of so mild a character that they would otherwise have escaped
detection, with the result that the notified cases were numerous, although the deaths few. It is
necessary to bear in mind the effect which this procedure necessarily has upon the fatality rate,
which is calculated on the cases notified and deaths resulting from diphtheria.
In many of the reports the number of instances is stated in which there was examination at the
public expense of material fro m the throats of persons suspected to be suffering from diphtheria. The
following show these numbers with the results obtained:—Paddington 36, 8 positive; Fulham 191,
42 positive; Westminster 102, 24 positive; St. Marylebone 42, 14 positive; St. Pancras 91,
24 positive; Islington 147, 61 positive; Stoke Newington 47, 21 pssitive; Hackney, 93, 42 positive;
Holborn, 13, 11 positive; Finsbury 61, 12 positive; Shoreditch 32, 5 positive; Poplar 293,64
positive; Bermondsey, 108, 20 positive; Lambeth 1,644, 111 positive; Battersea 165, 50 positive;
Wandsworth 174, 51 positive; Deptford 71, 30 positive; Greenwich 119, 31 positive; Lewisham 106,
34 negative; Woolwich 712, 102 positive. In these districts, therefore, there were 4,247 examinations,
and of these 757 or 17.8 per cent, gave positive results. These examinations do not include those that
were made in the laboratory of the County Council in the Education offices.
In connection with the question of the relation of school attendance to the spread of infection,
it has been thought well to include, as in previous reports, a table showing the reduction in the
prevalence of the disease among persons of school age during the summer holiday when the schools are
closed. The summer holiday of the schools of the London County Council began on Thursday,
the 27th July, i.e., the latter part of the 30th week, and the schools re-opened on Monday, the 28th
August, i.e., the beginning of the 35th week. If the number of cases in the four weeks preceding and