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150
Annual Report of the London County Council, 1912.
a rash, and this was diagnosed as scarlet fever. She was removed to the Grove Fever Hospital, Tooting.
The medical superintendent states that the mother gave provisional permission for the removal of the
finger should this prove to be necessary. It transpired, however, that amputation was not required.
R. C. was subsequently transferred to Gore Farm Convalescent Hospital, and discharged as cured on
27th March, 1911.
On her return to Brixton-hill school, she was placed in isolation, but used the same water closet
as the rest of the children. She was very pale; looked ill; the finger showed no suppuration, but a
piece of dead bone half-an-inch long protruded from the end of the finger. On 1st April she was released
from quarantine and admitted to Dormitory IV with 27 other girls.
On 8th April suppuration was observed and she was removed to isolation, where the sequestrum
was removed and the finger dressed. On 12th April she was notified as still being infectious and sent
back to the Grove Fever Hospital.
Meantime on 5th April the first case of a series of scarlet fever cases occurred in Dormitory
IV in the person of A. B., and in all 21 cases of notified scarlet fever and 15 cases of suspicious illness
occurred in this school. R. C. herself was, as aforesaid, again notified and sent to hospital, making
a total of 36 cases removed to hospital amongst 60 girls. None of the staff contracted the disease.
The dates of removal, and dormitories which the children occupied, are given in the table
below:—
7th April—A. B. —Dormitory IV.
10th „ — M. P. — „ IV.
12th „ — D. G. — „ IV.
12th „ — R. C. — „ IV.
13th „ — D. B. — „ I.
13th „ — M. W. — „ III.
13th „ — M. S. — „ III.
15th „ — I. B. — „ III.
15th „ — L. B. — „ III.
15th „ — K. S. — „ IV.
16th „ — L. R. — „ III.
16th „ — E. M. — „ IV.
16th „ — E. G. — „ III.
16th „ — B. S. — „ IV.
21st „ —F. D. — „ III.
21st „ — E. S. — „ IV.
21st „ — M. F. — „ IV.
25th „ — T. B. — „ III.
25th „ — E. D. — „ IV.
27th „ — A. C. — „ III.
27th „ — M. H. — „ III.
28th „ —A. A. — „ III.
Of the suspicious cases treated in isolation, a large proportion subsequently peeled and very
probably were cases of mild scarlet fever. Of these 11 were in Dormitory IV., and four were in Dormitory
III. Twenty-one of the 27 girls in Dormitory IV. and 15 of those in Dormitory III. were either notified
as cases of scarlet fever or came under suspicion.
R. C. was discharged from the Grove Hospital on 11th May, 1911, and kept in quarantine at the
school. She was still in a poor state of health and on 29th May returned to Dormitory IV., where there
were 27 other girls. From the date of her readmission to Dormitory IV. (29th May) until 27th July,
1911, there were no cases of sickness in the school, but on the latter date a girl, D. T., in Dormitory IV
was unwell and on 28th July exudate was discovered on the tonsils. She was immediately isolated
on suspicion of diphtheria. The child was bacteriologically examined, with the result that diphtheria
germs were found, and she was removed to the S.W. Hospital (Stockwell) on July 30th. Dormitory IV.
was put into quarantine and all precautions taken to prevent spread of infection. The whole of the
inmates of the school, including the staff, were examined bacteriologically on 31st July, onwards, and
those found to be carrying diphtheria germs or organisms of a suspicious character were classified;
isolated in separate dormitories and re-examined from time to time. There was at this time no adequate
accommodation for isolation, and all the dormitories being fully occupied, the staff found considerable
difficulty in arranging for the segregation of the groups in quarantine and of cases in isolation. At this
time keen vigilance was exercised to detect cases of sore throat and slight indisposition; these, when
detected, were isolated and bacteriologically tested from time to time. Between 31st July and 9th
August, nine children were isolated on suspicion, but only one (F.D.) was found to be definitely harbouring
diphtheria germs, and as she was suffering from sore throat and albuminuria, she was removed to hospital
Subsequently R. C. and another girl, E.M., continued to give positive results, although they showed
no clinical symptoms of diphtheria. In view of their continuing to be carriers, however, they were notified
as cases of bacteriological diphtheria and removed to hospital. The net result was that the school
was under observation from 28th July to 28th August, 1911, during which period two children were
attacked by diphtheria, whilst two others were notified as cases of bateriological diphtheria, and all four
children were removed to hospital. Analysis of the results of examination of cultures showed that 25
children were harbouring diphtheria germs at some time during the investigations, but were treated at
school and soon cleared up, four children were found carrying Hoffmann's bacilli, and 29 continued to
give negative results throughout. Of the two persistent carriers, R. C. was always pale and weakly, but