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33 per cent. of all large spore. T. sulphureum, 17 per cent. of all large spore. T.
violaceum, 9 per cent. of all large spore. This is a very rare species, (c) Small
spored type—(microsporon).—This genus is by far the most common fungus in London
and is responsible for 78 per cent. of all cases of ringworm of the scalp. It is a fungus
which very rarely attacks adults or the smooth skin even of children. It is
important that this latter consideration should be borne in mind as it is not
uncommon for school teachers or others to allege that they have contracted ringworm
from a school child, whereas on investigating the matter, it is trequently
found that the disease from which the aggrieved person is suffering is not
ringworm at all.
The following species of small-spored ringworm (microsporon) have been
identified in London school children—M. audouini, 89 per cent.; M. felineum,
2 per cent.; M. Lanosum, 2 per cent.; M. velvetium, 4 per cent.; other species so
far unidentified but different from those mentioned, 3 per cent. Miscrosporon
audouini is by far the most common species of fungus which affects London school
children. It is responsible for over 70 per cent, of all the cases coming under
observation.
During the past year a portable apparatus for the purpose of assisting in the
diagnosis of difficult cases of ringworm has been installed in the mcdical examination
room at County Hall. This apparatus is similar to the type employed for the
therapeutic use of artificial sunlight. A screen of Wood's glass is interposed between
the ultra-violet rays and the object for diagnosis. By this means only rays of a
certain wave length are allowed to pass, and these rays, by their property of fluorescence
throw all diseased hairs into prominence. It is an apparatus specially designed
for diagnosis and not for treatment, and as such should prove to be of value in
children's institutions.
Epidemic
jaundice.
An outbreak of cases of jaundice among school children attending Fircroft
Road L.C.C. School, Tooting, was investigated by Dr. C. A. Thornton, one of the
assistant medical officers. In all, 13 cases appear to have occurred, mostly in
April and May. The history of the symptoms appears to have been almost identical
in all cases, viz., a sudden onset with no premonitory symptoms, vomiting, anorexia,
rapidly followed by jaundice with clay-coloured stools and dark (sometimes " black ")
urine. The jaundice persisted from one to four weeks. There were no sequelae
or complications. As this outbreak was not reported immediately, there was no
possibility of suggesting that the urine should be tested for the presence of leptospira
icterohcemorrhagica. Such a test must be made in the early stages of illness
with any prospect of isolating the organism. No evidence of contact infection
could be traced. In seven of the cases there were brothers or sisters (in one instance
there were six) but only in one family was there a second case, and there was three
weeks' interval between them. There was also no evidence that diet had any causal
influence on the occurrence of the cases.
Epidemic catarrhal jaundice has frequently been associated with outbreaks
of influenza, and is regarded by some authorities as being one of the protean manifestations
of influenza. In this outbreak there were no cases of influenza at the
school, although it had been prevalent earlier in the year.
A similar outbreak among school children occurred in the Camden Town area
of St. Pancras during October and November. Several schools were affected.
Dr. Sowden, the medical officer of health, stated that the urine had been examined
in several cases for the leptospira icterohcemorrhagica. but with negative result.
He attributed the outbreak to ordinary catarrhal jaundice.
The standard of health of the children in the Council's residential, special and
industrial schools and places of detention, has, so far as infectious diseases are
concerned, been very good on the whole. At Homerton Deaf School, Penn, Bucks,
there was a small outbreak of German measles limited to four cases. At Clapham
Residential
special and
industrial
schools and
places of
detention