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during the prevalence of diphtheria in different districts, from medical
men frequently giving certificates of freedom from infectiousness in cases
which were actually at the time "carriers" of diphtheria. The matter
was discussed at a meeting of the Metropolitan Branch of the Incorporated
Society of Medical Officers of Health, and the following resolutions
passed:—
"i. That in the opinion of this Branch it is not possible in the
absence of a bacteriological examination to decide that a child is free
from infection of diphtheria.
"ii. In the event of the prevalence of diphtheria in any district,
any child excluded for sore throat should not be re-admitted to school
without a medical certificate of freedom from infection, based on a
bacteriological examination.
"Since then the London County Council have considered the matter
and passed the following resolution:—
"That the Education Committee be authorised to refuse, during
the presence of diphtheria in any district, re-admission to school of
children excluded on account of diphtheria or sore throat until such
children shall have obtained a medical certificate of freedom from
infection, based on a bacteriological examination.
"In the event of diphtheria becoming prevalent in a district the
teachers will therefore be instructed not to re-admit any child, who is
absent from sore throat or diphtheria, until they receive a certificate of
freedom from diphtheria, based on the results of a bacteriological examination.
The Medical Officers of Health will be kept informed of any such
orders to teachers.
"We propose to use a card for such cases when they are sent home
from school, giving the reason for exclusion, and stating that the certificate
can be signed by their own doctor, or, if necessary, the Medical Officer of
Health can be communicated with and will give such certificate, when the
child is free from infection, without cost.
"The present occasion may possibly afford an opportunity for the
Medical Officers of Health communicating with local practitioners as to
the importance of bacteriological recognition of diphtheria, and the fact
that when diphtheria is prevalent only certificates based on bacteriological
diagnosis will be accepted at once as satisfactory. It may be noted in
passing that several cases of "carriers" are known to us where doctors