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

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London County Council 1931

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

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The following statement shows the number of cases occurring amongst the children during the year, grouped in school terms, for each division:—

Division.Spring term.Summer term.Autumn term.Total.
N.E.11111530256
N.255236113
N.W.3232
S.W.1821113152
S.E.2027451
Total206215183604

The cases were all of the prevalent mild type. No vaccinated child developed
the disease.
One death occurred amongst the school children, the cause of death being
reported as (a) encephalomyelitis, (b) smallpox.
Records of the presence or absence of vaccination marks observed in the course
of routine medical inspection are set out on page 6.
Facilities for vaccination on the school premises by public vaccinators were
granted whenever applications for vaccination were received from the parents, and
about 1,000 children were vaccinated with the written consent of the parents.
It is found that, however mild the disease, the majority of persons attacked
fall ill three or more days before developing the characteristic rash. Children naturally
absent themselves from school as a result of this premonitory illness, and the operation
of the machinery which exists for notifying such absences through the school organisation,
results in immediate attention being drawn to the existence of such cases. These
factors are of special importance, for upon them is based the practice of allowing
healthy contacts to remain in attendance at school.
If, however, there was any evidence of the possibility of spread of infection in
the schools, arrangements were made for the special examination of the children 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 124, compared with 228 during 1930.
The services of the school nursing staff are 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 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.
Reference was made in my report of last year to the fact that after consultation
with the Ministry of Health and the borough medical officers of health, it had been
decided that the home contacts of cases of smallpox should be allowed to return to
school subject to their remaining in a normal state of health, and to their being kept
under daily surveillance in school by the school medical and school nursing staffs.
The employment of additional nursing staff was sanctioned to cope generally
with the work entailed by the supervision of schools in connection with smallpox,
and seven extra nurses commenced work in November, 1930.
A summary is given below of the reports of the school nurses on the visits made
to schools during the year in connection with the supervision of children in schools