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94
Use of public
washing
facilities by
school
children.
Arrangements were continued during the year whereby parties were taken
during school hours to the public washing baths in Camberwell and Kensington.
The number of baths given during 1924 was 4,025 in Camberwell and 6,306 in
Kensington, a total of 10,331. Applications have been made for an extension of
this scheme and at present negotiations are on foot for similar arrangements to be
made for other districts in London. Quite apart from the point of view of the
personal hygiene of the child the scheme is considered to be educational as can
be seen from the following extracts from letters written by the head mistresses of
schools in Kensington:—
"The children return from their morning dip not only cleaner but much
happier and more at ease, with that healthy glow about them which children ought
to have. These children are much better able to benefit by the day's teaching
than they ever were before and for many of them the bath is a far more educative
influence than anything we do in school."
"Now that the facilities are more widely known these people are showing
their appreciation by using the baths both in the evenings and in the school hours
for the children."
Infectious Diseases.
Diphtheria.
Although the incidence of diphtheria in public elementary schools in London
showed a progressive decline from 1921 to 1924, there has been a more rapid decline
of scarlet fever since the epidemic of 1920-21. Prior to the epidemic of 1920-21,
diphtheria had remained at a comparatively low level for many years, the number
of school cases occurring each year varying but slightly, whereas in the case of
scarlet fever the period from 1906-1924 (for which the school statistics are available)
was characterised by two decided humps in the epidemic curve, in 1907 and 1914,
before the wave of prevalence occurred in 1920-21. No such phenomena are to be
observed in the incidence of diphtheria, as will be seen in the diagram on p. 95, in
which the annual percentage of increase or decrease above and below the mean
number of cases of scarlet fever and diphtheria occurring in the schools during the
19 years, 1906-1924, is shown. To what extent the continued prevalence of diphtheria
is due to inflation of the notification figures by recourse to bacteriological methods
of diagnosis is a matter for speculation, but there seems to be no doubt that the
notification of mild cases, in which the diagnosis is made to depend upon a positive
report from the laboratory, plays no inconsiderable part. Prior to the introduction
of bacteriological aids to diagnosis, and when the incidence of diphtheria was at a low
ebb, such cases would probably have been regarded as ordinary sore throats, and in
some instances perhaps as mild scarlet fever. The unwonted prevalence four years
ago of diphtheria and scarlet fever, however, doubtless gave a stimulus to swabbing,
which has since been maintained and this may account in part for the greater prevalence
of diphtheria in London than in other parts of the country where bacteriological
assistance in diagnosis is perhaps not so readily obtainable. From the Council's
laboratory alone, out of 193 children found to be harbouring B. diphtherice, 119 were
notified as clinical cases and sent to hospital. Of these, 66 were children discovered
in elementary schools, and would probably in many cases have been missed but
for the supervision of the school medical service; 53 were from residential schools,
and many of them were removed to hospital, not so much on clinical grounds but
by reason of the impracticability of isolating them at the school. In addition
6 further cases in which merely suspicious organisms were found were subsequently
removed to hospital on private medical practitioners' certificates.
The number of cases of diphtheria reported from the schools during 1924 was
3,696, as compared with 3,985 (1923), 5,641 (1922), 6,661 (1921), 5,841 (1920). Onehalf
of the total cases in 1924 were reported during the autumn and winter terms
(i.e., between the Summer and Christmas holidays), the districts chiefly affected