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47
consultant to Goldie Leigh hospital, should visit the ship from time to time for the
purpose of examining the boys and advising as to preventive measures to be taken.
On Dr. MacLeod's recommendation the heads of all the boys on the ship were examined
from time to time, specimens from suspected cases being microscoped. Additional
medical staff was provided to assist Dr. Vickerman Smith, the medical officer of the
ship, with the daily examinations. A certain amount of washing of clothing, etc.,
had been carried out on board the ship. This was, however, discontinued; all
laundrywork being sent, after disinfection, to one of the Council's hospital laundries.
Special care was taken to prevent the promiscuous wearing of caps and clothing.
Dr. MacLeod kept the cases (which were treated by X-rays) under observation
at both the hospitals named above, and on his recommendation the boys who had
suffered from the disease were kept in quarantine for a period of three weeks after
they had been stated to be cured.
Dr. MacLeod reported that the disease was in the form of small red patches,
some of which were dotted over with yellow heads which were distributed on the
skin, in most cases on covered parts of the body, and that, though the lesions had
all the appearance of being due to a ringworm fungus, it was impossible from their
appearance to decide the exact fungus, and that on cultivation for a week the fungus
was found to be the trichophyton crateriforme (Sabouraud), one of the ringworm
fungi of the endothrix group which grows on the human skin and scalp and is not
of animal origin. He further stated that endothrix ringworm had been until recently
a rare variety of ringworm in this country, forming only four per cent, of the total
cases, and that it is more difficult to exterminate than the ordinary microscopic
type for the following reasons:—(i) it is more difficult to diagnose on the scalp,
as it commences in minute patches so small as to be difficult to find, and the broken
hairs do not form stumps but break off so short as to resemble blackheads ; (ii) the
infected hairs do not fluoresce with Wood's glass light; (iii) it is impossible to diagnose
it with certainty without a microscopical examination and possibly a culture;
(iv) it differs from microsporon ringworm in not dying out on the scalp at the age
of puberty.
Dr. MacLeod recommended that, as ringworm spores in the dry state remain
viable for at least six months, the ship should be evacuated.
Before entering the Hanwell school, every possible precaution was taken to
ensure that all the boys and their gear, etc., were free from any suspicion of
infection, but one boy was slightly infected with the same type of ringworm three
weeks after arrival at Hanwell.
The necessary cleansing and disinfection of the ship was completed during
February and March, and the boys returned in batches during the week ending
7th April. No case of the endothrix type of ringworm occurred amongst the boys
after that date.
In all, 122 boys were reported as suffering from body ringworm during the
outbreak.
The arrangements for the Schick-testing and active immunisation against
diphtheria of the children in the residential schools have been described in previous
annual reports.
Active
immunisation
against
diphtheria
in the
residential
schools, etc.

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