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

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London County Council 1938

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

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35
Passive
immunisation
before
tonsil and
adenoid
operations
Active immunisation against scarlet fever was carried out at four of the Council's
residential establishments, and a reference to this work is made later in the report.
At two treatment centres the practice obtains 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 preventing the occurrence of those diseases after the operations have been performed.
Parental consent is obtained in each case. This procedure has been in force at the
Cyril Henry treatment centre, Woolwich, since 1933, and at the Hanover Park treatment
centre. Peckham. since 1936.

The following figures relating to this pre-operative immunisation during 1938 have been received from the divisional medical officer:—

Cyril Henry treatment centreHanover Park treatment centre
Children attended1,4331,295
Operation performed1,1081,085
Operation deferred325210
Serum given920680
Serum not given because of—
Recent attack of scarlet fever or diphtheria Recent immunisation or recent reaction after antitoxin39216
History of asthma33
Parents refused consent146186
Serum rashes, etc., occurring among children passively immunised351174

One child at the Cyril Henry treatment centre suffered from scarlet fever after
the operation. The parents had consented to immunisation, but this was not done
as the child had been immunised a year previously in similar circumstances. The
previous high incidence of post-operative scarlet fever and diphtheria at the clinics
has disappeared.
Measles
The biennial epidemic of measles commenced in November, 1937, and for the
week ended 18th December. 1937, the number of school children reported to be
suffering from the disease was 324. After the Christmas holiday, the number of
cases reported in the four school days of the week ended 15th January, 1938, was
999, which number included absentees suspected to be suffering from measles.
The Council's scheme of control, which provides for special co-operation between
the school nurses, teachers, school attendance officers and borough medical officers of
health, in order to bring to the notice of the borough medical officers of health cases of
measles in their earliest stage, was put into operation on 12th January, 1938, and
continued until the incidence of measles in the schools had decreased sufficiently to
justify its suspension during the week ended 16th July, 1938.

The following figures indicate the numbers of measles cases reported among the elementary school population during this and the five previous epidemics. The figures relate to the epidemic period of nine months from November to July.

DateCases reported from schoolsAverage number on school rollsAttack rate per 1,000
1927-2845,343652,34269
1929-3036,634623,72859
1931-3235,705598,86560
1933-3438,949584,04967
1935-3632,690518,63063
1937-3835,292467,44275

It will be noted that the number of cases was greater than in the previous epidemic,
but less than in the 1933-34 epidemic. The attack rate per 1,000 was higher
than in recent epidemics. A detailed report on the epidemic is in course of preparation.
Ringworm
and favus
Cases of ringworm of the scalp occurring among children in the Council's
elementary schools are followed up by the school nurses, and, if any difficulty is
experienced in treatment by ointments and lotions, or if this treatment is considered
unsatisfactory,the parents are offered X-ray treatment under agreements made by the
Council with certain voluntary hospitals and treatment centres.