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After consultation with the London County Council Divisional Medical
Officer (Dr. Waldron) it was decided that the whole school should be
swabbed (Nose and Throat). As a result of this swabbing, 13 carriers
were found (11 living in Deptford and 2in Camberwell). The 11 Deptford
carriers were removed to the Brook Hospital and the 2 Camberwell
carriers to Hither Green Hospital.
All the children present in the school at the time were given either a
" booster " dose or a primary dose of Diphtheria Antigen (over 8 years
T.A.F. 1 c.c., under 8 years F.T. 0.5) and the Public Health Department
were given a list of absentees from the school.
Parents and brothers and sisters of the positive carriers were given two
Nose and Throat swabs. Parents under 30 years of age and children
not immunised or given a " booster " dose in 1961 were immunised in
accordance with the above antigens and dosage.
Brothers and sisters of those children in the class where the actual clinical
case was found were dealt with similarly.
Absentee children were swabbed and immunised later in their own
homes or by the family doctor.
Further absentees from school were notified to us day by day by the
London County Council and these were also visited, swabbed on two
occasions and immunised in accordance with the above procedure.
Special immunisation clinics were arranged in consultation with the
London County Council on Thursdays, 20th and 27th July (afternoons
and evenings) for those parents under 30 years of age and all brothers
and sisters of absentee children in the school, both junior and infants,
who had been notified to us. A circular letter was sent by this Department
to households concerned and arrangements were made to follow
up those absentees who were away from home owing to holidays or other
reasons.
We were given all the help that we required by the London County
Council Divisional Health Department, and for two full days we had the
services of at least two Health Visitors to assist us in the swabbing of
the absentees. The rest of the work was undertaken with our own
departmental resources.
It was known that about 80 per cent of the school had been immunised
previously and diphtheria anti-toxin was not used because of the possible
danger of serum reaction in susceptible cases. It will be appreciated that
only one clinical case had occurred and it was felt that in the absence of
further cases developing it was safe to rely on the eventual efficacy of the
active immunisation procedure adopted.
It was also decided because of our limited resources —and the time
factor—to dispense with the Schick testing of those parents to whom
immunisation was offered. The age of 30 for parents to qualify for
immunisation was chosen rather arbitrarily and has no special merit or
significance.
As a result of a second swabbing at the school, two further carriers
were discovered and removed to the Brook Hospital. The very extensive
swabbing of parents and contacts at home revealed negative results with
the exception of a single case to which reference will be made subsequently.