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187
Report of the County Medical Officer—Education.
and other materials used in connection with the scabies cases are kept apart. Cases attend at the
stations twice a week, but if the child is not cured after eight baths the case is reported for special
examination by the school doctor, and further baths are not given until definite instructions have
been issued. The stations at which children suffering from scabies are bathed are the Council's
H
stations at Central-street, Finch-street, Fountain-road, Sedlescombe-road, and the stations of the
Borough Councils of Battersea, Camberwell, Deptford, Greenwich, Hackney, Hampstead, Kensington,
Poplar, Marylebone, St. Pancras, Southwark, Westminster and Woolwich; cases are also bathed at
the station of the Corporation of the City of London.
The difficulties arising from the serving of the statutory notices, necessitated by the Children
Act, are accentuated by the fact that the children, after cleansing, become reinfected by contact with
members of the household who are above or below school age, and in regard to whom compulsory
powers for cleansing do not exist. This is particularly so in regard to cases of scabies, and it
sometimes happens that, although the local Medical Officer of Health has taken action in the
homes, as many as from 20 to 30 cleansings are given before a cure is effected. In one case 37 baths
were given.
The school nurses again assisted the executive committee of the Children's Country Holiday
Fund by examining for the detection of any infectious disease (e.g., ringworm) or any form of uncleanliness
among the children whom it was proposed to send to the country as soon as the summer vacation
began. The scheme comprised (1) a preliminary examination (2) an inspection beginning immediately
after the Whitsun holidays and ending within four weeks, and (3) a final examination during the last
two weeks of the terra. The object of the preliminary examination was to ascertain in good time the
children who would require special care and to warn the parents that if unsatisfactory conditions were
not remedied the children would not be sent on the holidav.
The
Children's
Holiday
Fund.
The first inspection at which a Children's Country Holiday Fund visitor was present, was made
at the ordinary rota visits, but for the purposes of the final inspection the nurses were authorised to
devote ten working days, beginning on July 6th, always provided that the arrangements for assisting
the school doctors at medical inspections were not disturbed. To facilitate the examination of the
children, at the final inspection, the schools were grouped and the children attended at a convenient
central school, the details of these arrangements being left to the nurses and the visitors or honorary
secretaries of the local committees.
The scheme worked very smoothly and gave general satisfaction; this was probably due to
the freedom in the matter of arrangements allowed to the nurses, who in many cases took much
trouble in order to ensure that the children should not be prevented from obtaining their holiday.
The Executive Committee of the Fund have again asked the Council to permit the nurses to assist
in the work.

Secondary
schools and
kindred
institutions—
Verminous
heals.
The following table shows the conditions found during the year:—
Examination, 1913.
Number of pupils.
Number found verminous
Percentage
Boys.
Girls.
Boys.
Girls.
Boys.
Girls.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Spring
75
3,840
-
165
-
4.29
Summer
75
4,144
-
249
—
6.00
Autumn
72
4,518
3
378*
4.16
8.36
*One of these was also a case of scabies.
Seasonal Prevalence of Fleas.
For the past five years effort has been made to obtain statistical information of fluctuations in the
seasonal prevalence of fleas. At first limited to observations made by the Council's inspectors of common
lodging houses, it has since the latter end of 1912 been found possible to broaden the scope of the inquiry
by the inclusion of material made available by the examination of elementary school children. In the
23610 BD 2