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To meet the expansion of the Council's chiropody service adaptations were carried out to
provide a second chiropody chair at each of the two Lewisham foot clinics. Full use of
the new sessions could not be made owing to shortage of chiropodists.
New boilers and radiators were installed at Rushey Green day nursery to improve the
hot water supply to the laundry and main nursery building and to provide improved heating
for offices on the floor above. At the divisional health office, improvements to the medical
examination room were carried out to provide adequate heating, lighting and sterilization
and the committee room was converted into offices for use by new mental health staff. By
arrangement with the Camberwell Borough Council, committee and other meetings were
transferred to the Town Hall.
Diphtheria—The year was marked, after a lapse of nine years, by two outbreaks of
diphtheria centred in schools in North Camberwell, both localised with no apparent
connection one with another. The first began in mid.November 1959, and a description of
the action taken was given in my report for that year. Swabbing of the pupils of three
schools involved was continued in the New Year, and special immunisation sessions were
held at school. The incident closed in mid.March, 1960. There were, in all, six clinical cases
of diphtheria, mild in character. As a result of swabbing 76 positive carriers were found;
with one exception (an only child treated at home by her doctor) all carriers were admitted
to hospital, and, after discharge, were required to show a further negative swab result before
returning to school. The Report of the Ministry of Health for 1959 (Part II, page 79) notes
that this outbreak followed a somewhat similar series of events to an outbreak at the same
time in North London caused by a similar type of organism.
The second outbreak had its onset in mid.December, but was not confirmed till the eve
of the school holidays. In rapid succession four pupils from Camelot school, Peckham
were confirmed as cases of diphtheria. Immediately the homes of class contacts were visited
by school health visitors and swabs taken. Twelve positive results were reported and family
doctors reported other positive results. The borough medical officer of health followed
up and swabbed the home contacts of all pupils found to be positive. There was close
cooperation with family doctors, to whom anti.toxin and antigen were issued, and guidance
on protection of the unimmunised family contacts of a case or carrier was given on request.
Frequent consultations were held with the physician.in.charge of the infectious disease
hospital and with the group pathologist. A special immunisation session was held for
family contacts and further swabbing visits were paid immediately after Christmas. A full
programme of swabbings and immunisations was instituted in the New Year. Up to that
time 28 children had been removed to hospital, of whom 11 were clinical cases. The
organism (C. diphtheriae mitis) that caused this outbreak was of a different strain from the
previous one; some of the children had severe attacks of the classical type and I regret to
report that one little girl aged seven years died on 7 January, 1961; she was unimmunised.
Maternity and child welfare—The statistical records were examined to ascertain the
effect of discontinuing the routine weighing of each baby at each attendance at a child
welfare session. As was expected, the total number of attendances had fallen. Attendances
for essential purposes, however, had not fallen; the number of babies coming and the
number seen by the clinic doctor had been maintained and more use had been made of the
educational classes, discussion groups and demonstrations given at the centres by the
health visitors.
Health visiting—The allocation of part of the time of a health visitor for special duties
with the King's College hospital diabetic unit was continued. She attends the unit once a
week, and visits the homes regularly to advise on general management, insulin therapy,
special diet and any family problems. The senior physician in the unit is very satisfied with
the arrangement, but it will be due for review in the light of the report of the Ministry of
Health Working Party on Health Visiting.
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