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tion of a large number of cases, that the school had certainly conduced to the spread of the complaint,
notably so at Victory-place School and at St. Paul's School, Sutherland-square. In each
case the infant department was the centre of infection."
Lambeth—The medical officer of health referring to the increase of diphtheria in Lambeth,
says, "Undoubtedly mild and unrecognized cases have been again to blame, so also the mixing together
of children in schools."
Battersea—Referring to an outbreak of diphtheria in Nos. 4 and 6 sanitary districts, the
medical officer of health says, " It was found that most of the cases were attending the infants'
department of the Plough-road School, and further investigations showed that a child suffering
from diphtheritic sore throat had been attending school without the true nature of her illness being
suspected, and it was not until other cases occurred in her family and in the same house that she
was medically examined, and found to have just recovered from diphtheria. I examined the
school and found that the whole of the children from the different class-rooms assembled together
in the main hall, and therefore recommended the vestry to close the whole of the infants' department
for three weeks. An order was made to that effect, the school closed and disinfected,
with the result that there has been no recurrence of the disease."
Wandsworth (Clapliam)—In discussing the manner in which diphtheria spreads, the
medical officer of health writes: "Thus, from February 15th to March 20th, there occurred 10
cases of diphtheria among infants attending the Westmoreland-street Board School, who were in
contact with each other at school, being in the same class-room and playing together in the playground,
but whose homes were in different streets. There resulted from these cases other secondary
ones in the infected houses. Probably some child with sore throat of a diphtheritic nature,
but unsuspected, had attended school, and so started this epidemic, but it was not possible, without
examining the throatls of all the children in the class-room, to be certain of this. Another instance
occurred in the Haselrigge-road Board School, where, at the end of September, several boys
sitting near each other in a large room, were notified within a few days as suffering from diphtheria,
the homes of some of them not being in the parish.
Woolwich.—The medical officer of health, Dr. W. R. Smith, writes—" During October a considerable
number of cases of diphtheria occurred among children attending the Powis-street Board School,
but a most careful investigation showed that in only a few of the cases could the infection have been
incurred at the school, the outbreak being for the most part due to causes operating in the locality
generally, the exact nature of which, however, could not be traced."
Among the appendices to this report will be found a memorandum by Dr. Young concerning
cases of diphtheria at the Council's Fire Brigade Station, Sun-street, Woolwich, See Appendix IX.
Let (Eltham)—As many as 28 cases of diphtheria were reported in 1898. Thte Board
School at Pope-street was " accountable for just half the 28 cases," and two of the scholars living
in Sidcup parish also suffered from the disease. The medical officer of health having received
notification of three cases on February 3rd visited the school and found that several other children
had been excluded from school on account of illness, or because they lived in infected houses. He
examined the throats of all the children in the infant school which had been attended by the three
children whose illness had been notified, found several with sore throats, and sent them home. He
then visited the homes of children who were absent from the school and found two other cases of
diphtheria which had not been notified. Two days later other cases were notified. Concerning the
sanitary condition of the school, Dr. Moore writes: "The principal factor in this outbreak was, I
have no doubt, the bad state of the latrine arrangements in the infant school. Representation
was made to the School Board and in September the sanitary authority ' issued a peremptory order
to the School Board to abate the nuisance.' This order was complied with the following
Christmas."
Plumstead—There were 110 cases of diphtheria notified in 1898, " Plumstead-road with
nine cases, and Earl-street and Burrage-grove with seven each, were the schools most affected."
For the purpose of ascertaining whether, as in previous years, there was a decrease of
diphtheria prevalence among children of school ages during the summer holiday, diagram XI. has
been prepared. The summer holidays of the schools of the London School Board began at noon
on Thursday, 21st July, i.e., the latter part of the 29th week, and the schools re-opened on Monday,
22nd August, i.e., the beginning of the 34th week. If the number of cases in the four weeks most
subject to the influence of the holidays be compared with the number notified during the four
weeks preceding and four weeks subsequent to the weeks of holiday influence, the following
results are obtained for the age-periods 0—3, 3—13, and 13 years and upwards. It will be seen that
the decrease in the number of cases notified during the period of holiday influence and the subsemient
increase in the period following is most marked at the school age, viz., 3—13 years—