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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and to enter on the admission form whether or not the child is known to have been
exposed to any infectious illness during the preceding three weeks, stating the date
of last contact. In the case of transfer from a Council's institution to a receiving
home, similar information is given on a prescribed form.
Children newly admitted to the receiving home are kept apart from the other
children pending medical examination. If passed as fit, the new-comers take their
places in the ordinary life of the home and are kept under daily supervision morning
and night by the matron or a responsible deputy, who has had some experience of
the recognition of infection in children. Due regard is paid to those children who
are stated to have been in contact with infectious illness, and diphtheria contacts
are kept apart pending bacteriological examination.
Any child showing signs of illness or any abnormal condition of the skin, eyes,
ears, throat or nose, is at once isolated and seen by the medical officer.
All cases of infectious illness (except scabies and impetigo) arising in any of the
schools or homes, are admitted without delay to one or other of the Council's
Prior to transfer from the receiving home to a residential school or children's
home, the child is medically examined and a certificate of freedom from infection or
exposure to infectious illness accompanies it to the school or home.
On entering a residential school or children's home the child is kept under supervision
as described above and provided it remains in normal health takes its place
in the ordinary regime of the institution.
If a case of infectious disease occurs in a children's receiving home, residential
school, or children's home, the contacts are examined night and morning for a period
appropriate to the disease by a nurse who has been instructed in the signs and symptoms
of the commoner infectious illness. Any child found to be ailing is isolated at
once, pending medical examination. Healthy contacts take their ordinary place in
the life of the school or home. Contacts of diphtheria are kept apart pending the
result of bacteriological examination.
Special procedure is laid down for occasional leave, and, unless there is any
special emergency, parents or guardians are required to give one week's notice when
applying for leave for their children in order that the relieving officer may make
enquiries as to the home conditions. Parents are required to state whether children,
on returning from leave, have been in contact with infectious illness.
Unless special emergency exists, relatives or friends are not allowed to visit the
schools or homes if infectious illness has occurred in their homes during the preceding
three weeks, and they are required to sign a declaration before their visit is allowed.
The successful working of the scheme depends entirely on the conscientious
fulfilment of the instructions laid down for the various staffs. The relieving officers
and the medical officers and other staff of the receiving homes, residential schools and
children's homes have co-operated loyally, and the smooth working of the new
arrangements is attributable solely to the excellence of their work.
As may be expected, special circumstances arise occasionally, and these are
referred to officers in the public health department.
The following is a brief review of the cases of infectious illnesses which were
reported from the residential schools and children's homes, during 1931:—
Diphtheria.—A few groups of cases of diphtheria were reported. Arrangements
were made for the immediate swabbing of the contacts and the facilities afforded by
the Council's laboratory at the County Hall were placed at the disposal of the medical
officers of the institutions. The number of swabs submitted for bacteriological
examination was 849. Of these, 46 cultures (including two re-examinations) showed
the presence of micro-organisms morphologically indistinguishable from B.diphtheria;
37 of the cases (35 children and 2 staff) were officially notified and removed to infectious
hospitals. Tests for virulence were applied to 29 of the cultures; 26 of these
were reported to be virulent and three avirulent. The avirulent carriers were allowed
to resume the normal regime of the institution.