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47
The immunising agent in most common use is toxoid antitoxin mixture (T.A.M.). This
agent was used in twenty-three of the twenty-four areas in which immunisation had been adopted
up to the end of 1935. Eight of the areas in which there have been facilities for immunisation
for the longest periods have continuously adhered to its sole use. In one borough, the use of
T.A.M. has been restricted to the cases of younger children, toxoid antitoxin floccules (T.A.F.)
having been reserved for older children and adults. In fourteen areas T.A.M. has been supplemented
or replaced by other prophylactics of later production, e.g., toxoid antitoxin floccules in
nine areas ; alum precipitated toxoid (A.P.T.) in seven areas ; toxoid antitoxin (goat) in two areas.
A reference to the active immunisation against diphtheria of children in the
Council's residential schools and homes appears later in this section of the report.
The incidence of scarlet fever among the children on the school rolls was again
unusually low, 3,903 cases being reported, compared with 4,852 cases during 1936,
and an average of 7,100 for the years 1931-1936 inclusive. There was an even distribution
of the cases throughout the year.
A reference to immunisation against scarlet fever, which is being carried out in
three of the residential establishments for children, appears later in this report.
References have been made in previous annual reports to the practice which
has been carried out at the Cyril Henry treatment centre, Woolwich, since 1933,
and at the Hanover Park centre, Peckham, since October, 1936, of passively immunising
children against scarlet fever and diphtheria with a combined antitoxin
consisting of streptococcus and diphtheria antitoxins before tonsil and adenoid operations,
with a view to the prevention of the occurrence of those diseases after the
operations are performed. Parental consent is obtained in each case

As noted in previous reports, no case of scarlet fever or diphtheria occurred at
either centre amongst those injected. Two cases of scarlet fever occurred at the
Hanover Park treatment centre amongst those not immunised. No serious aftereffects
of the injection occurred amongst the children.
The biennial epidemic of measles was due to begin in the autumn of 1937, and,
from information furnished by the head teachers, it was evident that it had commenced
in certain parts of London towards the middle of November, 75 cases being reported
during the week ended the 13th of that month. The average number of cases reported
weekly during the preceding eight weeks was 46.
The following statement shows the number of cases of measles reported from
the schools during the first stages of this, and of the three preceding epidemics:—
1931-32 1933-34 1935-36 1937-38
Nine school weeks preceding Christmas holidays 1,568 1,899 1,032 1,553
First six weeks of spring term 4,809 7,065 3,928 6,425
It is evident that the present epidemic developed rather more rapidly than the
last epidemic and approximated, in this connection, to the epidemic of 1933-34.
The special scheme of co-operation between the school nurses, teachers, school
attendance officers, and borough medical officers of health (through their health
visitors), to which reference has been made in previous annual reports, has again
been put into operation during the present epidemic. 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, so that consideration may be given to the question of providing home
nursing facilities through the borough health services or of arranging for the admission
of cases of the disease to the Council's hos2)itals. In January and February, 1938,
the scheme was applied to 210 schools, and leaflets containing advice to parents,
issued by the borough medical officers, were distributed in the schools concerned.
According to past experience, the epidemic is likely to last until July, 1938.
Scarlet
fever
Passive
immunisation
against
scarlet
fever and
diphtheria
at treatment
centres
Measles