London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1911
[Report of the Medical Officer of Health for London County Council]
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Report of the Medical Officer (Education).
125
of trouble, before admitting her to class all treatment of the throat which might have interfered with
the growth of organisms was intermitted, when almost at once, although the throat was doubtful, cultures
from the nostrils were teeming with diphtheria. So also with the other child who had returned with 11.
C. She was returned to hospital on November 11th and her companion not clearing up was sent off on
November 17th. The companion rapidly cleared, but four months later, R. C. is still in hospital, whilst
the school itself appears free from disease. Cultures taken from her after Easter, 1912, still present the
Klebs-Loeffer bacillus, which was found to possess virulency when tested on animals.
Dr. Helen Hanson has investigated the frequency of the diphtheria bacillus in the ear discharges
found in children in elementary schools. There are many varieties of diphtheroid organisms found in
secretions of eyes, ears, nose or throat, and actual diphtheria organisms have been isolated from pustules
or sores about the face, but without actual tests for virulence by inoculations it is often impossible to
be quite certain that the true diphtheria organism is present. In these cases, which were bacteriologically
examined in detail by Dr. Ludwig Rajchman, the reactions were morphologically and by culture
such that if taken from throat swabs they would have been diagnosed as diphtheria. Some cases are
returned as suspicious in that though they gave most reactions they were not quite typical perhaps
morphologicallv, or at least that without a virulence test to confirm the diagnosis it could not be positively returned as diphtheria.
Aural
discharge
and
diphtheria.
The schools where the enquiry was made were noted as follows:—
| Name of School, | Department. | Approximate Roll. | N umber with Ear Discharges. | Number with suspicion of , Diph. Bacilli. | Positive finding of Diph, Bacilli. | School history for past six months, |
|---|---|---|---|---|---|---|
| Aldenham-street | B | 313 | 15 | 1 | 1 | 0 boys, 2 girls sufferers. |
| G | 309 | 15 | 3 | 1 | ||
| I | 300 | 2 | - | - | ||
| Amwell-street | M | 500 | 4 | - | - | - |
| Ann-street | B | 229 | 6 | - | - | - |
| G | 338 | 2 | - | - | ||
| I | 287 | 6 | - | - | ||
| Buckingham-street | B | 380 | 6 | - | - | 1 girl, 1 boy, 1 infant suffered, 3 infants contacts. |
| G | 386 | 3 | 2 | 1 | ||
| I | 503 | 8 | - | - | ||
| Camden -street | I | 450 | 5 | — | 1 | 3 infants suffered. |
| Detmold-road | B | 400 | 5 | — | - | — |
| G | 400 | 5 | — | - | ||
| I | 400 | 6 | — | - | ||
| Herbrand -street | B | 130 | 6 | 1 | 3 | Numerous cases of tonsilitis, no diphtheria reported. |
| G | 114 | 5 | 1 | 1 | ||
| High-street (Stoke Newingten) | B | 232 | 3 | - | - | 3 girls and 1 boy suffered, 3 boys contacts. |
| G | 200 | 9 | 1 | 1 | ||
| I | 251 | 6 | 1 | — | ||
| Lancing-street | B | 200 | 1 | - | - | 1 girl sufferer. |
| G | 275 | 4 | - | 1 | ||
| I | 174 | 2 | - | - | ||
| • Manehester-strect | B | 450 | 4 | 3 | - | 1 boy and 2 girls sufferers, 5 girls contacts. |
| G | 437 | 8 | 3 | 1 | ||
| I | 425 | 5 | - | - | ||
| Prospect-terrace | B | 331 | 5 | 1 | - | 2 girls home contacts. |
| G | 400 | 5 | 2 | l | ||
| St. George-the-Martyr | B | 144 | 4 | - | l | 0 boys suffered. |
| Totals | 8,958 | 155 | 19 | 13 |
There was no connection traceable between previous diphtheria in the school or family and the
occurrence of the bacilli in the aural discharge. In none of the cases traced back for six months had a
case been recorded in the person or family of one of the diphtheria bearing discharging cars. There
was just an indication of seasonal influence in that the spring cases showed 20 per cent, with diphtheria,
the summer 34 per cent., and the autumn 22 per cent.
The increasing number of cases of measles in the last half of 1910 was the prelude to an epidemic
outburst, long expected, but short and sharp, in the spring of 1911.
Measles.
Measles is certainly the most serious of the zymotics, accounting in this country for one quarter
of the deaths in the second and third years of life. The only consolation is that it is selective and
that the majority of the fatalities are probably among the best spared weaklings.
The recent 1910-11 epidemic was not confined to London, although here the reduced prevalence
during the past ten years, by increasing the proportion of persons liable to the disease, may have
accentuated the suddenness and extent of the outbreak. Still the deaths from measles in 1911 were