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77
Seven notifications of "secondary" cases were received. From two hospitals
in the Borough 17 in-patients were notified as so suffering. None was resident in
Holborn.
Two of the cases notified were "return" cases.
The child, V.S., giving rise to these two cases was found to have catarrhal nasal discharge
and enlarged glands at the angle of right jaw. The child after return home from hospital
slept by herself and was kept away from school for two months from the date of return home
from hospital and was then found on further examination by the Medical Officer of Health to
be fit for return to school and a certificate was issued accordingly.
There was no death from this disease.
15,855 cases of scarlet fever were notified in London with 77 deaths.
Every endeavour is made to co-operate with the London County Council in connection
with infectious diseases. For instance, a child who was a contact with scarlet fever was
kept at home by its parents on the grounds that the child was "a carrier of scarlet fever."
On the Medical Officer of Health going into the matter, no evidence of this was to be found;
the child had slight enlargement of the tonsils, but was considered fit for school.
Acute Rheumatism in Children.
The Holborn (Acute Rheumatism) Regulations of 1929 came into
force on the 1st April, 1929; these require the notification of acute rheumatism
in children up to the age of sixteen years.
Acute rheumatism as defined by the Regulations means—
(i.) Rheumatic pain or arthritis, if accompanied by a rise in
temperature;
(ii.) Rheumatic chorea (St. Vitus' dance);
(iii.) Rheumatic carditis.
Forty-eight cases were notified from the 1st April, 1929, up to the end of the
year. As regards the source of information:—
3 were notified by doctors in private practice.
2 were notified by an Assistant School Medical Officer.
9 were notified by doctors in institutional practice.
11 were notified by the Medical Officer of the Rheumatism Supervisory
Clinic.
23 were notified by the District Organiser of the L.C.C. Care Committee as
having been definitely stated medically to be suffering from rheumatism.
Rheumatism in children attending school is from time to time reported to the Health Visitors
by parents ; if the child is not already notified as suffering from rheumatism, the information is
given to the District Organiser of the L.C.C. Care Committee (Miss H. Bell, to whom we have
reason to be grateful) at a monthly conference between the Organiser and the Health Visitors.
Miss Bell arranges for medical examination of the child at school.
Of forty-one cases reported by parents to the Health Visitors, the diagnosis of rheumatism
was confirmed in eleven.
The notifications are classified as:—
Rheumatic tendency 2
Sub-acute rheumatism 22
Acute rheumatism 12
Post-rheumatic 12