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Immanuel School.—On October 6th, attention was drawn to the Immanuel School, Streatham.
A number of cases of diphtheria had occurred here before notice was received, many of the children
came from outside the Metropolitan area, and the occurrence of diphtheria in their homes was not
notified to the school (compare Eardley Road School); in fact the head mistress had been for 15
years ignorant of the name or address of the Medical Officer of Health of the district from which
a large proportion of her children came. On October 6th, out of 43 children from whom cultures
were taken, 8 showed the presence of diphtheria bacilli. These children had mostly suffered from
"sick headache" or sore throat during the previous fortnight; they were all in Standard II. (aged 8).
As the outbreak was notified late, and the number of "carriers" excessive, it was determined to close
the school, but before doing so, a visit was made on October 11th, and further 34 children examined
bacteriologically. Three further cases were discovered, all of whom had symptoms of illness
(headache or nasal discharge).
St. George's School.—On October 14th another outbreak in a Non-provided School came under
notice; at St. George's, Hanover Square, again owing to the fact that the arrangements for taking
over the Voluntary schools were incomplete, knowledge of the conditions was delayed. Seven cases
of diphtheria had occurred in one class (aged 6) in quick succession, from September 29th to
October 10th. The whole of the class was examined, 42 cultures being taken; amongst these 3
"carriers" were found and excluded. One or two cases occurred within the incubation period after
the visit, but no further cases, and the outbreak was arrested. A second visit was made on October
19th, but no case found amongst the cultures taken.
Mtrton-road School.—In one class in the Infants' Department (age of children 5—6), 4 cases of
diphtheria were notified between November 4th and 22nd. A visit was made, and all the children
presenting suspicious appearances were swabbed; amongst these 2 children were found harbouring
Klebs-Loeffier bacilli, and when they were excluded no further cases occurred.
Plumslead Central School.—During the Christmas holiday a communication was received from
Dr. Davies, Medical Officer of Health for Woolwich, pointing out that many cases in that borough
had been connected with these schools before and during the vacation, and asking that an investigation
should be made. Accordingly, on January 11th, a visit was paid on the re-opening, and all
the children examined; the majority of the cases had occurred in the upper classes of the Infants'
Department. Forty-two cultures were taken, and one or two "carriers" were detected and excluded.
Further cases, nevertheless, occurred, and a second visit was paid on January 23rd; one baby
(F. R.) was ailing in school and was found to be suffering from diphtheria. The cause of the
continued occurrence of cases was, however, found in a little girl, D. G. (age 7), who had recently
returned from hospital for scarlet fever. Amongst half-a-dozen children who had been to hospital
for this complaint it was noticed that D. G. had a slight nasal discharge. All these scarlatinal
returns were swabbed, but D. G. alone showed one or two Klebs-Lœffler bacilli in the nasal
discharge; she was excluded and the outbreak at school ceased entirely. To prove that she was the
source of the trouble, some days after her exclusion a brother took the complaint from her and was
removed to hospital.
Uglinton-road School.—During January, Dr. Davies pointed out that a number of cases had
occurred in connection with the Infants' Department at this school. On February 3rd the whole of the
children were examined, and 30 cultures taken; 2 "carriers" were found amongst these, and
excluded, whereupon the outbreak ceased as regards this department, though later on in March
and April further cases occurred in a class in the Girls' Department.
Church Manor Way School.—On March 6th a visit was made, and 35 infants swabbed after
the examination of the whole department. Four "carriers" were excluded, 3 of whom presented
symptoms, and the remaining one came from a diphtheria house.
Mitcham-lane School.—On March 15th, in consequence of a communication from Dr. Caldwell
Smith, the Infants' Department of Mitcham-lane was inspected, and 44 cultures taken. Amongst
them a boy (P. H.), aged 6, was found to be a "carrier," and excluded; 2 other children with suspicious
growths were also excluded. Eighteen children had been excluded from this department
during the 12 weeks previous to the visit made, no further exclusion took place during the 8 weeks
subsequent (up to date).