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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The cases were all of the mild type and without exception 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, 70 children in one school 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,
was continued. These contacts were kept under daily supervision by the school
nurses, whose services have again been used in connection with the daily surveillance
of schools attended by children notified as cases of smallpox.
The following table summarises the reports submitted by the school nurses
in connection with this work:—

Table 23.

Division.No. of visits to schools. (No. of schools concerned in brackets.)No. of cases of smallpox found as a result of examination by school nurse.No. of children excluded by school nurse with suspicious symptoms.No. of home contacts supervised in school.No. of absentees (home contacts) reported to borough medical officer of health.No. of hours devoted to work.
N.E.16 (9)--455
N.535 (27)7298734344
S.W.109 (6)13434
S.E.160 (11)283974
Total820 (53)72913282457

Experience of the type of mild smallpox again showed the difficulties arising
from the numbers of missed cases, and efforts were directed to ascertaining at the
earliest possible moment the reasons for absence from school. As a result of
intensive investigation and close co-ordination between the officers of the school
medical and nursing service, the school attendance staff and the borough health
services, a few previously undetected cases were brought to light.
The biennial epidemic of measles, which began in London in the autumn of
1933, continued until July, 1934. During the period of the epidemic (9 months)
38,949 cases were reported from the schools, compared with the 35,705 reported
during the epidemic (9 months) of 1931-32. A special report dealing with various
aspects of the epidemic, such as incidence, mortality, treatment, administrative
measures, use of serum, is being prepared for publication.
The following are the numbers of schools kept under daily supervision for
varying periods by the school nursing staff on account of the diseases mentioned :
whooping-cough, 38; chickenpox, 134; mumps, 111.
In the course of their visits to these schools, the school nurses inspected the
children and advised the head teachers as to exclusion or re-admission to school.
A reference to the action taken in connection with the ascertainment and
treatment of cases of scabies appears elsewhere in this report. The children at two
schools were kept under special observation for a time by school nurses on account
of the occurrence of several cases of the disease amongst the children.
Minor outbreaks of ophthalmia occurred during the year at four schools.
The children in the affected schools were kept under supervision by the school
medical and school nursing staffs, working in close co-operation with the borough
health services. Measures were taken to obviate the spread of infection through
the use of school towels.