London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1920

Annual report of the Council, 1920. Vol. III. Public Health

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92
Ringworm
and favus.
For several years prior to 1919, the number of cases of ringworm discovered in the schools had been
steadily diminishing. During the past two years, however, there has been some retrogression, for in
1919, there was an increase of 800 cases over the previous year, followed by a further rise in 1920. The
actual number of fresh cases reported during the year under review was 3,983, as compared with 3,447
in 1919, and 2,639 in 1918. It is satisfactory to record, however, that the number of cases cured
maintains a satisfactorily high level, 3,856 cases laving been cured during 1920, thus keeping pace
almost with the increase in the number of cases reported. At the end of the year there were 1,332
children known to be suffering from ringworm.

The appended Table shows the number of fresh cases reported annually during the past decade, together with the cured cases and the number known to be suffering at the end of each year.

Fresh cases.Cured cases.Cases outstanding at the end of theyear.Fresh casesCured cases.Cases outstanding at the end of the year.
19116,2145,8722,45819163,1153,08111,232
19125,3115,1312,20419172,8142,9641992
19135,5735,2572,27719182,6392,555979
19144,4495,9021,63819193,4473,1031,259
19153,7473,9281,33419203,9833,8561,332

Dr. Chaikin, the divisional medical officer for the eastern division, states that from 1914 onwards
the incidence of the disease in the East End, steadily diminished until the summer of 1919, a period
which " coincided with the absence of the permanent nurses on war service, as a result of which much
of the diagnostic skill for ringworm exhibited by this branch of the service was not available." Dr.
Chaikin points out that the causes favouring the spread of ringworm still exist. In this connection the
importance of suitable cloakroom accommodation in the schools is emphasised. With regard to treatment,
the objection of parents to X-rays is being overcome, but the unsatisfactory method of treatment
by ointments is still favoured by many medical practitioners ; under this form of treatment
years may elapse before a child is cured. The persistence of doctors, both in private practice and in
hospitals, in giving certificates of freedom from ringworm, even after the parents have been informed
that the fungus has been demonstrated in the Council's laboratory, militates to some extent against
the efficient control of ringworm. From time to time cases in which the diagnosis is disputed by a
private doctor or by hospital medical officers are referred to Dr. Brincker, one of the Council's principal
assistant medical officers, and almost invariably the diagnosis is confirmed microscopically and the
parent is persuaded to continue treatment or preferably to place the child under X-ray treatment.
There was a slight increase in the number of cases of favus reported during the year, viz., 10 as
compared with 7 in 1919, of these 5 cases occurred in the East End.
During 1920, 3,239 specimens of hair stumps were examined in the Council's laboratory, of which
1,662 proved to contain ringworm fungus, whilst 11 showed the presence of favus.
Dr. Chaikin's
report on
favus in the
East End.
Dr. Chaikin refers to cases of favus dealt with in the eastern division from the year 1911 to the
end of 1919. As systematic supervision by nurses was undertaken, more and more cases came under
notice. The numbers increased steadily up to 1915, when there was a very marked decline of new
cases. No doubt the fact that migration from eastern Europe was suspended accounts for this. Boys
seem to be almost equally affected with girls, though the latter are fewer by 10 in the cases found.

The following table shows the number ot cases reported in the last ten years in the East End of London.

YearNo. of cases.YearNo. of cases.
1911119167
1912419175
19132419184
19143019193
19152119205

Dr. Sequeira,. of the London Hospital, drew attention during 1920, to the number of cases of
favus coming under treatment there and attributed the increase to the influx of aliens. In this
connection the attention of the Council was directed to difficulties which were being experienced in
regard to the accommodation of transmigrants passing through London from Poland and other
provinces of Eastern Europe en route for Canada and the United States. Many of these aliens were
found to be suffering from diseases such as favus, trachoma, and other infectious conditions. On this
account they were debarred from entry into Canada or America, and thus the anomalous position was
created that transmigrant aliens suffering from infectious diseases constituting a danger to the public
health could remain in London and become a charge upon the public health resources of the Metropolis
as well as a menace to health, until they could be pronounced cured and fit for admission to another
country. Appropriate representations were accordingly made to the Minister of Health, who was