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About the same time there was a rather undue incidence
of the disease on St. Mary's School, Albert Road, and also on
George Street Board School and some other schools in the
neighbourhood of Nunhead. Closure of the schools was not
called for, as there was nothing in the progress of the series of
cases that would lead one to believe that there was an undiscovered
focus of infection still attending the school, and
in the case of St. Mary's School there was not the fact
present of that school being especially attacked while the
remaining schools in the immediate vicinity practically entirely
escaped.
In my report for last year I mentioned the fact first
described in a report to the International Congress of Hygiene
in 1894, by Professor Welch, of Baltimore, that virulent
diphtheria bacilli had been found after the lapse of so long a
period as seven weeks from the disappearance of the membrane
from the throat; and subsequent experiments by various
observers have placed the correctness of this assertion beyond
dispute. This has such an important bearing on the time
which should elapse before the return of children to school
after they had had diphtheria, that I sent out a circular letter
to all the public and private schools whose existence I was
aware of, stating that occasionally children had returned to
school without a certificate of disinfection having been sent by
us, pointing out that we often intentionally delayed the
issue of this certificate, and also drawing attention to the
necessity of having a bacteriological examination made of the
throats before the children return to school. We now also
send a letter to the head of the house where a child is attacked,
saying that it will not be possible for the children to attend
school again until a notice of disinfection has been sent by us
to the school. I should withhold a certificate of disinfection
in cases where children had remained at home until I had had
an opportunity of taking a specimen for bacteriological examination,
but not in the case of those removed to the Metropolitan
Asylum Board's Hospitals as I understand that bacteriological
examinations are made as a matter of course before the child
is returned to its home.
The heads of the school can therefore co-operate with
xii.