London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1924

[Report of the Medical Officer of Health for London County Council]

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96
being Islington, St. Pancras and Bethnal Green in the north, and Bermondsey,
Deptford, Southwark, Camberwell and Lambeth in the south. In Bermondsey
the outbreak was centred chiefly in schools bordering on the river, and several
deaths occurred ; at Laxon-street School, which suffered the most, the cases practically
all occurred in November and amongst the children under five years of age.
Some deaths occurred. Large numbers of the pupils were swabbed and certain
children were found to be carrying diphtheria germs. After repeated visits by medical
officers the outbreak subsided.
In Southwark and Camberwell diphtheria persistently occurred within a triangular
area (each side being about one mile in length) formed by Camberwell Newroad,Kennington
Park-road and Camberwell-road. The schools chiefly affected were
Comber-grove, Beresford-street and Faunce-street. At Comber-grove the children
under five were chiefly affected, and although repeated examinations were made,
and swabs taken from time to time, few children were found to be harbouring
diphtheria bacilli. The greater number of the cases occurred after the return of
children from the hop-fields, where housing conditions were said to have been unsatisfactory,
and it was assumed that the inclement weather during the hopping
season may have had some effect in lowering the vitality of many of these children.
The Faunce-street outbreak was practically confined to October, and the younger
children were mostly affected. Only three carriers were found, but it was reported
that large numbers of children were suffering from catarrhal symptoms. The
children mainly came from clean two-storied dwellings.
During 1924, investigations were made in 174 departments (96 schools) and some
16,000 children were inspected. The bacteriological examinations numbered 3,973
(including re-examinations), of which 314 showed the presence of germs morphologically
indistinguishable from diphtheria, although no virulence tests were carried
out; 294 raised some suspicion and were referred for further examination. The
remainder were negative. The total number of actual carriers found was 193.

The success attending these endeavours to accelerate the return of children is reflected in the following table :—

Period of absence from school.1920.1924.
Carrier cases.Approx. percentage.Carrier cases.Approx. percentage.
Up to 4 weeks3246623380
4-8111224415
8-12 „275103
Over 12 ,,31621

Diphtheria at
residential
schools.
It may be of interest to comment briefly on outbreaks of diphtheria which came
under notice during the course of the year at two of the Council's Residential Schools,
and one at an Army Training School, where the boys attended one of the Council's
Elementary Schools.
(i.) Mayford Industrial School.—The occurrence of diphtheria at this school in
boys between the ages of nine and sixteen years would more accurately be described
as a series of sporadic cases than as an outbreak. Five cases occurred altogether,
separated by intervals of five, eight, twelve and eight weeks respectively. The
first boy was isolated with a suspicious throat on 23rd March ; a swab revealed the
presence of diphtheria bacilli and he was removed to hospital. No further cases
occurred until 25th April, when another boy was isolated, swabbed with positive
result, and removed to hospital. A sharp watch was kept by the medical officer