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The surgeons were asked to have adrenalin at hand for immediate injection in such cases
if it appeared advisable. One surgeon decided to give an intra-muscular injection of adrenalin
before the antitoxin and reported that there had been no signs of any ill effects even with a
history of diphtheria only two months before.
The sister in charge has provided the following statistics for the two periods of the year:—
1st January to 30th April.
(No injection if child had previously had scarlet fever or diphtheria.)
509 children attended.
75 operations deferred as child unfit.
280 children given combined serum.
86 children were not injected because they had had previous attacks of scarlet fever
or diphtheria.
68 parents refused.
1st May to 31 si December.
1,152 children attended.
158 operations deferred as child unfit.
892 children given combined serum.
9 children not given serum because of recent immunisation.
4 children not given serum because of history of recent asthma.
89 parents refused.
Six children had a slight serum rash during their stay at the centre and 377 others were
reported by nurses visiting after the operation to have suffered from serum reaction, but none
was seriously ill.
During the year three children were diagnosed as suffering from scarlet fever after operation
at the centre:—
Case 1.—Operation 30th January, 1935; scarlet fever 4th February, 1935. Antitoxin
not administered owing to parental refusal.
Case 2.—Operation 13th March, 1935; scarlet fever 19th March, 1935. Antitoxin
not administered as child had previously suffered from diphtheria.
Case 3.—Operation 19th March, 1935; scarlet fever 23rd March, 1935. Antitoxin
not administered as child had had injection before a previous operation.
Measles.
The completion of the report on the measles epidemic in London of 1933-34,
to which reference was made in the last annual report, was unavoidably delayed.
It was published in April, 1936.*
References were made in this report to various aspects of the epidemic, including
incidence, mortality, hospital provision and treatment, and home nursing, and a
special section was included dealing with the use of serum in measles prophylaxis.
The biennial epidemic was due to begin in the autumn of 1935, and, from the
information furnished by the daily reports of the head teachers, it was evident that
it had commenced in certain parts of London towards the end of October, 78 cases
being reported during the fourth week of that month. The average number of cases
reported weekly during the preceding eight weeks had been 31.
The following statement shows the numbers of cases of measles reported from
the schools during the first stages of this and of the two preceding epidemics:—
1931-32. 1933-34. 1935-36.
Nine school weeks preceding
Christmas holidays 1,568 1,899 1,032
First six weeks of spring term 4,809 7,065 3,928
It is evident that the present epidemic was unusually slow in developing.
The special scheme of co-operation between the school nurses, teachers, school
attendance officers and borough medical officers of health (through their health
visitors) was reviewed in consultation with the borough medical officers of health
and the education officer during the summer months, and a few minor alterations
were made as a result of experience gained in previous epidemics. The object of the
scheme is to bring to the notice of the borough medical officers of health cases of
measles in their earliest stages, in order that consideration may be given to the
question of providing home nursing facilities through the borough health services
or arranging for the admission of cases of the disease to the Council's hospitals.
During November and December the scheme was put into operation in 23
schools. Leaflets containing advice to parents, which are issued by the borough
medical officers, were distributed in affected schools.
* Report of the Medical Officer of Health and School Medical Officer on the Measles Epidemic, 1933-34.
No. 3180. Price 1s.