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The matter first came to my notice on Tuesday, 7th February,
when the Medical Officer of Health of Islington advised me that a child
attending the Centre, but resident in his borough, had been admitted to
hospital and was clinically a severe case of diphtheria. On receipt
of this information, immediate enquiries were commenced at the Centre,
and the Divisional Medical Officer of the London County Council was
informed. Steps were immediately taken to protect all the children
in the Centre by giving Antitoxin to the un-immunised and "boosting
doses" to those with a history of immunisation. An extensive programme
of swabbing was undertaken, not only in the Centre, but in the families
of children in the Centre and in the school classes attended by other
members of their families.
The position was complicated by the fact that the children
involved lived in five boroughs; Hammersmith, St. Pancras, Paddington,
Islington and Westminster. Further, one of the cases, residing in
Kensington, had attended a children's party in Westminster, attended by
60 children from 15 local authorities' districts. The situation was
further involved by the fact that the pupils attending a neighbouring
Occupation Centre shared the same school bus.
Only one of the children attending the Centre who lived in
Kensington was a clinical case of diphtheria, and was in fact discovered
by the staff of the Public Health Department.
Details of the outbreak were sent to the Ministry of Health,
and to Medical Officers of Health of other local authorities concerned.
All contacts and children living outside Kensington who had directly or
indirectly been exposed to infection, were referred to the appropriate
Medical Officers of Health for surveillance.
On 8th February, a circular letter was sent to 350 doctors
practising in Kensington, advising them of the outbreak, indicating the
localities where the children lived and urging the importance of bearing
in mind the possibility of diphtheria in all cases of sore throat, nasal
infection or other similar symptoms.
On 10th February, a further letter was sent to all local
practitioners advising them of the position then obtaining in the outbreak
and indicating where supplies of immunising material could be
obtained; which London County Council immunisation centres were
available and the scheme of immunisation which was officially recommended
for children of various ages.
With the authority of the Chairman of the Public Health
Committee, a Press Statement was issued, drawing attention to the outbreak
and urging parents to ensure that their children were adequately
immunised either by the family doctor or at one of the London County
Council immunisation clinics.
Enteric Fever
During the year there were 3 cases of typhoid fever.
The first case concerned a 29-year old male who occupied a
single room letting. He was treated for typhoid fever at Guy's
Hospital, ten weeks after having arrived in this country from
Australia. Faeces, urine and blood specimens taken by the hospital
were persistently negative for organisms. In view of the patient's
history, enlarged spleen and positive widal, the patient was
considered to have suffered from typhoid fever modified by previous
T.A.B. inoculation. Specimens submitted by contacts proved negative.
The second case involved a man aged 39 who was admitted to
hospital suffering from vomiting, exhaustion and loss of weight. He
had just returned from Rome and Sardinia, where he had experienced the
same symptoms. Upon arrival in this country his condition deteriorated