View report page

31
St. George-the-Martyr.—In connection with the increase in the prevalence of diphtheria in this
district the medical officer of health recommends the frequent and systematic inspection of schools,
inasmuch as " in such places early and undetected cases of diphtheria, in the sore-throat stage, are to
be found under circumstances that afford every opportunity for the spread of infection."
Lambeth.—Referring to an outbreak of diphtheria among the children attending a school in the
Ferndale-road, and which necessitated the closing of the school, the medical officer of health states that
" in very many cases pseudo-bacilli were isolated from the throats of the scholars, servants and teachers,
whilst in three cases the true Klebs-Lceffier bacilli were isolated, pointing apparently to the two kinds
of bacilli being related in some way." In examining the slimy deposits in the waste pipes of the
lavatory basins in the dormatories and in the outlets of the open rectangular trough underneath the
basins a pure culture of the Klebs-Loeffler bacillus was obtained. These troughs were subsequently
removed. The outbreak had been preceded for some months by the occurrence of cases of throat illness
in the school.
Battersea.—An outbreak of diphtheria occurred in the early part of the year, due to the
attendance at infants' department of the Plough-road Board School of a child whilst suffering from an
unrecognized attack of diphtheria. This child's illness was not discovered until two other members
of the family were attacked and a medical man was called in. Thirty cases of diphtheria were found
to be more or less associated with this case. Dr. Kemp3ter states that the infants' department was
closed on the 10th February and that "during the four weeks preceding the closing of the infants'
department, 34 cases had occurred in No. 6 district, being equal to 8'5 per week, whereas during the
first week after the school closure, a portion of which would be within the incubation period and
consequently the full effects of the measure would not be experienced, the number was reduced to six
cases for the week, and during the second week one case only, the improvement being subsequently
maintained."
Wandsworth (Clapham).—In discussing the cause of diphtheria, as an instance of the influence
of direct infection, Dr. Field refers to a series of cases occurring among children attending the NewPark-road
Board School, a new school with all modern improvements. Fifteen cases occurred in a
period of time extending from early in February to Easter. Many of the children were nursed at
home, and as a result other members of the families were attacked, 13 other cases occurring, or 28
in all. Dr. Field says that " It is most probable that there was some child or children going about
in an infectious condition possibly to school during February and March, and that other children were
directly infected. The outbreak came to an end with the Easter holiday, only one case being reported
after the re-assembling of the school. In a special report he discusses the prevalence of diphtheria in
Hydethorpe-road, in 17 houses of which 25 cases of diphtheria occurred in a period extending
from November, 1898, to November, 1899. Of these 25 cases, 13 were under 5 years of age, 11 from
5 to 10 years, and one above 10 years of age. Most of the children in the road go to the Cavendishroad
School, and 12 other diphtheria case3 occurred after August among children attending
this school from adjacent parts of Streatham and Clapham other than Hydethorpe-road. Dr. Field
writes " Seeing that so large a proportion of the cases were of infants below school age, and the absence
of any marked association of the sufferers in classes, and the small total number, it does not appear
that school attendance has had any marked effect in spreading diphtheria." He comments on the fact
that the houses in this road were newly built, and were occupied before they were dry.
Camberivell.—Account is given by tho medical officer of health of the prevalence of diphtheria
among the infants and girls attending tho Heber-road Board School, and affecting 27 in all. From
the 2nd October to the 1st November among families invaded by diphtheria the first member attacked
was in 20 instances attending the infants' department, and in seven instances was attending the girls'
school. Dr. Stevens arranged for the bacteriological examination of material from the throats of five
children taken at random from two classes where the disease, judging from the notifications received,
was most prevalent at the time. Examination of this material by Dr. Bousfield showed that " in one
case diphtheria bacilli were present, in another specimen their presence was doubtful, while in three
the specific micro-organisms were not discovered." The infants' department was closed on Dr. Stevens'
recommendation, and he states that in the three weeks following the closing of the department only
seven primary cases were notified among the children attending the school, one the boys' department,
two the girls, and four the infants' department, three of whom were probably infected before the infants'
department was closed. This result he attributes to " the destruction of the focus of infection by the
closure of the school."
Woolwich.—There was increase in the number of cases notified in Woolwich during 1899, due,
the medical officer of health state3, to two outbreaks, one on the" Warspite " training ship in August
and the other among children attending Elizabeth-street Board School, North Woolwich. The
outbreak on the Warspite was found by the port medical officer of health to be due to a case of
diphtheria introduced into the ship ; the origin of the cases in connection with the Elizabeth-street school
could not be traced. Dr. W. R. Smith writes—" The children affected, with two or three exceptions,
all lived in one particular area, one street having four cases. It was found on enquiry that the
children were in many instances in the habit of playing together, and in some cases of visiting each
others houses. The large room of the infants' department, where most of the children were, was
closed and thoroughly disinfected."
Eltham.—The medical officer of health refers to a small outbreak in which the cases " were among
scholars at the Board School or among those who had been in immediate contact with them."
For the purpose of ascertaining whether as in previous years there was decrease of diphtheria
prevalence among children of school age during the summer holiday, diagram XI. has been prepared.
The summer holiday of the schools of the London School Board began on Thursday, the
27th July, i.e., the latter part of the 30th week, and the schools re-opened on Monday the 28th
August, i.e., the beginning of the 35th week. If the number of cases in the four weeks preceding