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

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St Pancras 1898

[Report of the Medical Officer of Health for St. Pancras, London, Borough of]

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31
symptoms should be excluded, especially children suffering from sore-throat; and
also, when measles and whooping cough are prevalent, children suffering from
catarrhs, colds, and coughs should be excluded; and if not already detained by
the malady, children suffering from diarrhoea in the heat of the summer should
be sent home.
With the guidance of the foregoing principles the exclusion of particular
scholars, or of a particular group of scholars, is sufficiently indicated. It is not so
easy to decide when it is justifiable to close an entire school, or a department of a
school. It may be definitely said that a school divided into departments, carried
on in separate and distinct premises, should, if possible, be closed by departments
in preference to the closure of the whole school, but the difficulty is to decide when
to close a department, that is to say, to answer the following questions: (1) What
number of the classes must be infected to justify the closure of a department, and
(2) what number of scholars must be excluded for inspection to justify the closure
of a class ?
In answer to the first question, the scholars of a department, although in
different classes, may come into contact at many points on the school premises, and
if every class in the department have on the roll a few scholars excluded or infected
by a disease which is so prevalent as to necessitate the closure of one or more
classes in the department, it is reasonable to assume that generally the best precautionary
measure may be the closure of the department.
But we are still thrown back upon the second question, the decision as to when
it is justifiable to exclude all the scholars from a particular class or from particular
classes occupying one class room. By the individual exclusion of scholars that may
themselves be infected, or that may come from an infected house, a class or a classroom
may be so depleted as to practically close itself; it is obvious that action
should not be delayed till such a condition or any approximation to this state has
established itself, or to await the exclusion of one-half of the children, or perhaps
even of one-third.
Of course, all questions of closure, that is, of entire exclusion, are largely dependent
upon the prevalence of the disease in the neighbourhood. It would not
be justifiable to close a class or a department when the disease is not prevalent in
cpidemic form, but is accidentally or negligently spread by the presence of a
scholar suffering from the disease in an unrecognised or modified form, since upon
the discovery and exclusion of the sufferer, and those infected and suspected, the
chances are that its course will be arrested.
On account of the prevalence of measles in the neighbourhood and in the schools,
it was found necessary in June to close the Infants' Department of the Home and
Colonial Practising Schools in Gray's Inn Road, and also the Infants' Department
of the National Schools in Camden Street.
The prevalence of diphtheria amongst the scholars of the Board School,
Haverstock Hill, also necessitated the closure of that school just before Christmas,
for a period of a month.