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of the school with a view to isolating and swabbing any boys developing sore throat,
but no further cases occurred until eight weeks later, when a boy was isolated with
a sore throat and was sent to hospital on a positive bacteriological finding. All
three were treated at Guildford Isolation Hospital, and it was reported that the
illness was very mild with very little membrane on the fauces. They were discharged
on 2nd May, 6th June, and 28th July respectively after two negative swabs had been
obtained. After the third case, as many boys showed abnormal conditions of the
throat, ear or nose, they were swabbed, but the specimens did not yield diphtheria
bacilli. In July all the boys, except those under any suspicion, went into camp
at Ramsgate, after consultation with the medical officer of health of that district.
They returned in much improved health, and the school presented a clean bill of
health, as regards diphtheria, until 11th September, when another mild sporadic
case was reported. This boy was sent to one of the Metropolitan Asylums Boards
hospitals. During the time these cases were occurring reliance was placed
on careful supervision and isolation of suspicious cases. On 3rd November a
boy was isolated with a sore throat and was removed to a Metropolitan Asylums
Board hospital after a positive bacteriological examination. This case proved to
be the only one which could not be described as mild, as the boy was said to have
"well marked faucial diphtheria of moderate severity." The whole school, including
the staff, were now swabbed, and two of the boys were found to be carrying diphtheria
germs, and five had suspicious organisms; these cleared up in a comparatively
short time. As a further precaution Woking and neighbouring hamlets were ruled
out of bounds. At the time of writing (March, 1925) no further developments
have occurred. Exhaustive enquiries were made to discover whether any common
cause could have been responsible for this sporadic diphtheria, but nothing definite
could be elicited. There was no evidence that any of the boys whose swabs yielded
a positive or suspicious result were acting as distributors of infection.
(ii.) Newport Market Army Training School, Westminster. This is not under
the Council's jurisdiction, but the boys attend one of the Council's schools. Attention
was first called to the occurrence of diphtheria at the institution on 26th November,
1924, when it was discovered that sixty-five boys from the training school were absent
from St. Matthew's school, Westminster, as possible contacts of diphtheria. Between
that date and 16th December nine cases of diphtheria (one fatal) occurred. All
the boys at the training school and certain of the staff were swabbed, with the
assistance of the Council's medical officers ; nine boys were found to be carrying
germs of dipththeria and were removed to hospital. Only one of them, however,
showed definite clinical symptoms of diphtheria. After the removal of these boys
no further cases occurred until 12th January, 1925, when one of the boys, who was
absent from the school in a general hospital the previous term when swabbing was
carried out, developed diphtheria. Further inspection of boys was then arranged
and in the meantime attendance at day school was suspended. The bacteriological
examination resulted in three boys being removed to hospital as carriers, including
one who gave a positive result on the previous occasion and had been discharged from
hospital. On 1st February a fresh case was reported and following upon further
swabbing of contacts two boys were found to be harbouring diphtheria bacilli and
were removed to hospital. As a result of this outbreak the Schick test was applied
to this school under the auspices of Drs. Monckton Copeman and W. M. Scott of
the Ministry of Health in conjunction with Dr. Shinnie, Medical Officer of Health
of Westminster. Some 70 of the boys were thus tested on 4th March ; 13 out of
the 70 showed positive reactions and these received their first immunising dose
of toxin antitoxin followed by a further dose the following day and a third dose
one week later. It was decided to applythe test to all new admissions to the school.
(iii.) Bushy Park Residential Open-Air School.—(See p. 87). Between 25th
November and 1st December an outbreak of diphtheria took place when seven boys