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48
The cases were found to be due to the epidermophyton inguinale, the most common fungus
of body ringworm in this country. The parts specially affected by it are the crutch, armpits,
and between the toes, with occasional small satellite patches present elsewhere. This fungus
never affects the hairs. The possible causes of the spread of this type of infection are latrines,
underclothes, towels, insufficient washing and lack of care in drying the toes.
In addition to a special examination of the boys twice a day after washing, various
measures were taken in accordance with Dr. MacLeod's recommendations, including
the remodelling of the W.C. seats, the replacement of the woollen pants worn by the
boys by cotton cellular trunks, the provision of thin cotton undervests which could
be easily washed and sterilised; the prevention of cracking and scaling of the skin
between the toes by strict supervision of bathing parades, and the proper disposal
and drying of towels after use.
Acting on instructions issued in a circular sent to medical officers of residential
schools and homes where there are girls, 20 cases of vaginal discharge were reported
during the period July to December (apart from the remand home); 15 of these
were transferred to hospital for observation. No evidence of gonococcal infection
was found in any of these cases.
Thirteen cases of vulvo-vaginitis were transferred from the remand home to
hospital. As a result of bacteriological examination, gonococcal infection was
found to be present in 5 of them, and they were retained in hospital for appropriate
treatment. The remaining 8 cases were negative.
In connection with these instructions, the matrons and women superintendents
of the schools and homes concerned were invited to County Hall, and the methods
of detection and of dealing with cases of suspected vulvo-vaginitis were explained
fully by one of the Council's women medical officers.
The arrangements for the Schick-testing and active immunisation against
diphtheria of the children in the residential schools, children's homes, residential
special schools and approved schools have been described in previous annual reports.
Vulvovaginitis.
Active
immunisation
against
diphtheria
in residential
establishments
for
children.

The medical officers of the schools reiterate the opinions expressed last year
that there has been little or no local or general reaction to the prophylactic agent
(formol toxoid) and that the process of immunisation has not interfered with the
ordinary routine of the children in the schools and homes.
The following report from Dr. R. D. Milford, medical officer of Hornchurch
children's home, is worthy of note:—
I think it is of interest that, during a severe epidemic of diphtheria in this district occurring
in the summer and autumn of 1934 and the spring of 1935, although all the outside schools
which are attended by our children were involved quite heavily, yet no single case occurred
among the children of this institution. I think this can be taken as evidence of the effectiveness
of the measures taken against diphtheria. Actually about 85 per cent. of our children have
been Schick-tested and either found negative or rendered negative by toxoid administration.
On 20th November, 1935, the Education Committee approved the introduction
of active immunisation against diphtheria at Ardale approved school and on
4th December, 1935, a similar scheme was sanctioned for Cumberlow Lodge approved
school. The work at these two schools was begun early in 1936.