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6,200 of school age between 5 and 15 years and 800 over the age o f 15 years. It is
estimated that about 70 per cent. of those who have undergone protective inoculation
attend for further Schick testing 3 to 6 months later to ascertain if inoculation has
resulted in successful immunisation. The work done in the welfare centres during
the past year may be judged by the following figures of those tested and immunised
in 1929:—2,273 were Schick tested, 1,633 were found Schick positive (71-72 per
cent.) and 2,376 had been immunised or were being immunised, yielding a total for
the year of 3,150 naturally immune or immunised individuals.
In addition to the preventive work for which the borough councils are responsible
at the welfare centres, the use of the Schick test and active immunisation, has been
now for several years a routine measure at a number of residential homes and
institutions in the County and in Greater London; they include Poor Law Guardians
schools, homes, orphanages, training and masonic schools, numbering about 20,
at which up to the end of 1929 a total of 13,444 individuals had been Schick tested,
yielding 5,346 (just under 40 per cent.) Schick positive and 5,165 who have been
immunised, representing a further total of 13,260 naturally immune or immunised.
The higher proportion of Schick negatives, 60 per cent. immune, is due to the fact
of their being older children than the majority at the welfare centres.
In several of the suburban districts in the outer ring of London, preventive
inoculation against diphtheria has also been provided as part of the child welfare
work of the municipal health centres.
In Ilford County Borough, in view of the marked increase in diphtheria, particularly
on the Becontree Estate, a preventive clinic was started by Dr. A. H. G.
Burton during 1929 in November, and up to the end of February, 1930, a total of
150 children under the age of 5 years had been and were being immunised, and 889
school children had been Schick tested, 737 (83 per cent.) Schick positives had been
or were being immunised, i.e., a total of 1,039 known to be immune or in process of
being immunised.
As to the results, it may be said briefly that they are best judged in the case
of residential institutions, which without known exception, have yielded the most
satisfactory and much desired effect of complete freedom from infection, in contrast
to previous experience of frequent outbreaks of diphtheria. From the totals most
courteously supplied by the medical officers of health of the various boroughs and
districts concerned, as well as by those in medical charge of residential institutions,
it may be stated that in the aggregate, in Metropolitan and Greater London, about
26,000 individuals, the great majority under the age of 15, are now known to be or
are being protected against diphtheria by means of toxoid-antitoxin inoculation.
The control
of measles.
During 1929, 19,313 cases of measles and German measles were reported from
the Council's schools.
It was stated in the Annual Report for 1928 that the next epidemic of measles
was expected towards the end of 1929, and that it was hoped to profit by experience
and to make the administrative control of measles even more effective than during
the last two epidemics.
The suggestion, approved by the Council, that the metropolitan borough
councils should be invited to adopt a system whereby the health visitors, during an
epidemic of measles, should meet the school nurses and co-operate directly with
them in regard to suspected absentees from school, was considered in 1929 by the
metropolitan branch of the Society of Medical Officers of Health. Thanks to the
hearty co-operation of the hon. secretary, Dr. J. Fenton, medical officer of health of
Kensington, a very satisfactory response was made by the other metropolitan
boroughs ; none objected, and the degree of uniformity of the method of control
throughout London promises better results than ever in the way of securing the
early treatment of measles sufferers. Owing, however, to the greater demand for
beds on the Metropolitan Asylums Board on account of the extended prevalence of