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

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London County Council 1934

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

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43
The distribution among the five divisions was as follows :—

Table 21.

Division.Visits paid.Numbers examined.Numbers excluded.Cases of scarlet fever and deaths, all ages.
Cases.Deaths.
No.Per, 1,000No.Per 100,000
N.E.273,522333,1024.1131.7
N.374,819952,9423.6111.4
N.W.283,133483,0373.4101.1
S.W.739,9181074,3064.4131.3
S.E.696,9951224,8855.2192.0
Total23428,38740518,2724.15661.5

In all 8,850 cases were reported in the schools, representing an attack rate of
16.8 per 1,000 of children on school rolls, or 18.8 per 1,000 of those in attendance.
The figures with regard to the incidence and case mortality are provisional and
subject to correction in the various boroughs concerned.
Reference was made in the last annual report to the practice which had been
adopted at the Cyril Henry treatment centre of immunising children against
scarlet fever and diphtheria before tonsil and adenoid operations, with a view to
the prevention of the occurrence of those diseases after the operations had been
performed. The practice was continued during 1934 subject to parental consent
being obtained in each case. The following report on the results obtained has
been received from Dr. H. R. Kidner, divisional medical officer:—
Scarlet fever.
Cyril Henry
treatment
centre.
Pre-operation immunisation against post-operation scarlet fever and diphtheria has been
continued throughout the year 1934.
No case of either disease was reported as following the operation in any child who received
the injection, but two children, who were not injected because they had suffered from previous
attacks of diphtheria, were certified as suffering from scarlet fever and removed to fever hospitals
two days and five days, respectively, after the operation. One other child was admitted to
the South-Eastern fever hospital seven days after operation, notified as suffering from diphtheria,
but it was proved on bacteriological tests to be streptococcal tonsillitis.
Statistics for the year are as follows—
1,523 children attended for operation.
216 „ were deferred for operation on that day as unfit.
938 „ were injected with the combined serum.
276 „ were not injected because they had had previous attacks
of scarlet fever or diphtheria.
93 parents refused consent.
Two children had a serum rash during the two days stay in the centre, and 87 were
reported by the nurses visiting the homes subsequently as suffering from a " reaction," usually
an urticarial rash; the parents are all warned that this may happen and in no case was the
child reported as being seriously affected. The operating surgeons are satisfied that the
inoculation is of value. One reports definitely fewer cases of pyrexia, to which he was called
after the operation, in the proportion of roughly 6 to 1, and he has adopted the procedure in his
private practice.
The sister-in-charge reports fewer post-operative complications such as haemorrhage and
sepsis.
During the year, 144 cases of smallpox were notified (and confirmed), and of
these 46 were among school children. All these cases occurred during the period
January to June. The few cases notified after June proved not to be smallpox.
The following statement shows the number of cases occurring among school children
grouped in school terms, for each division:—
Smallpox
among
school
children.

Table 22.

Division.Spring term.Summer term.Autumn and winter term.Total.
N.E.----
N.255-30
N.W.----
S.W.2-2
S.E.10414
Total37946