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Scarlet fever.
Scarlet fever was epidemic in London during the latter half of 1933, and this is
reflected in the number of cases (11,357) reported from the schools during the year.
This is the highest number of cases of the disease reported from the schools since
1921, when 17,030 cases were reported. As a result of special examinations in
school by the Council's medical staff, a few cases of very mild type were discovered
and notified, and a number of children excluded from school on account of such
findings as sore throat. In 176 schools the children were kept under observation
by the nursing staff for various periods.
Scarlet fever.
Cyril Henry
treatment
centre.
A number of cases of scarlet fever occurred during the year amongst children
who were operated upon at the Cyril Henry treatment centre for the removal of
tonsils and adenoids. Nineteen cases were reported, the last case being removed to
hospital on 25th October, and in most instances the disease developed shortly after
the operation. Every care was exercised at the centre, and swabs were taken from
the sister in charge together with the rest of the staff. In no case, however, was any
organism revealed suggestive of scarlatinal streptococci.
After careful consideration, it was decided that, subject to the previous consent
of the parent or guardian being obtained, each child should be passively immunised
against scarlet fever before the operation on the throat was performed. It was
later considered advisable that each child should also be protected in the same
way against diphtheria attack, although no cases of that disease had been reported
amongst the children.
A combined antitoxin consisting of streptococcus and diphtheria antitoxins
was prepared at the Council's Belmont laboratories and issued to the centre in
ampoules of 5 c.c.
The work of immunising the children against scarlet fever commenced on 20th
November, and against scarlet fever and diphtheria on 5th December, 1933. Since
that time and up to 14th February, 1934, injections have been given to 226 children.
The parents of 7 children refused consent, and 19 children were not injected because
there was a history of a recent attack of scarlet fever or diphtheria. In no case was
any complaint made to the surgeons subsequently that the child was ill in any way.
No cases of scarlet fever or diphtheria have been reported amongst the children
since the procedure was inaugurated.
Smallpox
among
school
children.
During the year, 531 cases of smallpox were notified in London, and of
these 170 were amone school children.
The following statement shows the number
of cases occurring among these during the year, grouped in school terms, for each
division:—
Division.
Spring term.
Summer term.
Autumn and
winter term.
Total.
N.E.
45
12
1
58
X.
2
7
9
N.W.
S.W.
26
36
5
67
S.E.
1
6
29
36
Total
74
61
35
170
The cases were all of the prevalent mild type and all the cases occurred amongst
unvaccinated children.
Facilities for vaccination on the school premises by public vaccinators were
granted whenever applications for vaccination were received from the parents,
and, at the written request of the parents, about 400 children in 4 schools were
vaccinated.
The special arrangement whereby home contacts of smallpox are allowed to
attend school if in a healthy condition, which has now been in force for some years,
has been continued. These contacts are kept under daily supervision by the school
nurses, whose services have again been extensively used in connection with the
daily surveillance of schools attended by children notified as cases of smallpox.