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foreign body was found in the nose and removed. This body was so incrusted that
its nature could not be determined, but as the ulceration healed so the swabs
became negative."
Diphtheria
prevention
in London,
1930.
A special report on diphtheria prevention by means of the Schick test and active
immunisation has been prepared for inclusion in the Scientific and Medical Supplement
to the Annual Report of the Council for the year under review.
Smallpox
amongst
school
children.

The cases were all of the prevalent mild type. In one case it was reported
that a vaccinated school child developed smallpox. With this exception no vaccinated
child developed the disease.
Two deaths occurred amongst the school children the causes of death being
reported in the first case as (a) encephalomyelitis, (b) smallpox ; and in the second
case as (a) pyaemia, cause unknown, (b) smallpox discrete modified.
Facilities for vaccination on the school premises by public vaccinators were
granted whenever applications for vaccination were received from the parents.
Comparatively few applications were, however, received and only about 300 children
were vaccinated with the written consent of the parents.
In the majority of cases children suffering from smallpox had not attended
school in an infectious condition. If, however, there was any evidence of the
possibility of spread of infection, arrangements were made for the special examination
of the children in the school to be conducted by one of the assistant medical officers
and for the children attending the school to be kept under daily observation by the
school nursing staff. The number of special visits paid to the schools by the assistant
medical officers in this connection during the year was 228, of which 177 were in the
north-east division.
The services of the school nursing staff are being extensively used in connection
with the surveillance of children in schools attended by children notified as cases of
smallpox. The necessity for supervision is determined by reference to the relative
dates of the onset of illness and of the last attendance at school. The affected schools
are visited daily by the nurses for a period of 19 days from the date of attendance of
the last case in the school.
During the spring term 32 cases of smallpox were notified as a result of the
school nurses' reports. These were all in the Poplar, Stepney and Bethnal Green
areas.
During the summer term 135 schools were at one time or another under the
special supervision of the school nursing staff and 67 cases of smallpox were notified
as a result of their reports.
During 1930 efforts were made to deal with the problem of home contacts of
school age. Under the Council's regulations the children concerned were excluded
from school for a period of 16 days and the task of supervision in the homes was
becoming a matter of some difficulty, especially in the areas in which smallpox was
most prevalent. Apart from this consideration an enormous amount of school
attendance was being lost.