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Home nursing equipment—There has been a steady growth in the demand for home
nursing equipment which includes commodes, hospital beds, foam rubber mattresses,
wheelchairs and hoists and during the year 160 patients were supplied with 178 items.
Prevention of break-up of families—The divisional co-ordinating committee met nineteen
times during the year under the chairmanship of Dr. M. T. Paterson, the deputy divisional
medical officer, to discuss general policy affecting the work of official and statutory agencies
in the area and to direct and co-ordinate casework. Fifty-three new families engaged the
attention of the committee and reviews were undertaken of eleven others which had been
before the committee previously.
Central syringe service—In co-operation with the Paddington Group Hospital Management
Committee, a scheme was started as an experiment by which their central syringe
service supplies syringes and needles for clinics in the division. The service provides for the
delivery and collection of sterile needles and syringes in sealed containers. A fresh syringe
and needle is used for each person.
DIVISION 3, comprising the boroughs of Finsbury, Holborn and Islington
Dr. W. G. Harding reports:
Diphtheria—In last year's report I referred to the detection of a number of carriers of
C. diphtheria mitis and of some mild cases in three schools in the division. In June, 1959 a
positive throat swab was obtained in a boy who visited a local hospital on account of an
injury and also complained of a sore throat. This boy attended Moreland school, one of
the three schools involved in 1958. Further swabbing between June and September revealed
sixty children at that school with positive throat and nose swabs. Almost all were admitted
to hospital, a number of them with clinical involvement of throat or nose, or with a past
history of this, but in view of the extremely mild clinical condition of most of the children
in whom any signs appeared at all any rigid differentiation between 'cases' and 'carriers'
on the old pattern appears impossible. It seemed likely that the infection had been kept
smouldering by carriers with unhealthy throats and noses and also septic skins. Special
attention was therefore focused in that school on the discovery of such children by daily
visits by the school nursing sister and frequent visits by the medical staff.
In order to discover whether there was any widespread incidence of carriers in the
schools, throat and nose swabs were taken in three classes each of two junior schools in
the same district, but all produced negative findings. However, in October two children
attending an infant school less than a mile away were found to have sore throats and the
same organism was again isolated. Altogether eight children were found to carry the
organism in this and another school which used the same premises. Shortly afterwards a
positive throat swab was returned from a child with tonsillitis from another junior school
and later in the year two further children from that school were found to carry this germ.
In yet another junior school there was a similar incident affecting altogether 31 children,
and there were isolated occurrences in five schools involving nine children, some of them
family contacts of children affected in the earlier incidents.
Altogether 106 swab-positive school children were discovered in ten schools in the course
of the year; no definite link could be established between the schools except in some of the
last-mentioned sporadic incidents.
Following the reappearance of cases in Moreland school a procedure was agreed with
the borough medical officers of health and the director of the Public Health laboratory
service laboratory, designed to minimise the risk of infections gaining a foothold in the
schools. This involved the swabbing of all children in the school (or school department),
if, following the discovery of a positive swab, class swabbing revealed one or more further
cases. Absentees and home contacts were followed up rigorously and on discharge from
hospital—or in very rare instances from treatment at home—a further independent negative
swabbing was required before exclusion from school was lifted.
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