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The teachers in the schools keep the Public Health Department
well advised of any little outbreaks of non-notifiable infectious
diseases which take place amongst the school children, but we have
no similar organised help with reference to the adult population.
Intimate touch, however, is maintained with the private practitioners
working in the area and we confidently believe that almost
all such outbreaks are in one way or another brought to the notice
of the Public Health Department.
A comprehensive system obtains whereby intimations of
disease received from the schools or through the investigation
officers are utilised so far as practicable. Cross references are made
for the use of the health visitors and school nurses, who follow up
cases of whooping cough, mumps, measles and other similar nonnotifiable
infectious diseases.
(b) Rheumatic Fever.—It is very difficult in Barking to deal
with rheumatic fever. The condition is very prevalent, and
unfortunately, so far as symptoms are concerned, rather mild,
although the number of cases of disorderly action of the heart found,
particularly amongst young people, clearly indicates that the condition
is by no means so trivial as the symptoms would lead one
to believe.
Rheumatic fever, as a public health problem, differs from
scarlet fever, with which it is closely allied, because it has no rash.
This is the most unfortunate thing about the condition. If there
were only some such significant sign much more notice would be
taken of it.
In this connection it is happy to recall the painstaking
endeavours of the Boots Minor Sub-Committee of the Education
Committee of the Council to provide boots for the bairns, and
although certain members have, I believe, incurred the possibility
of disciplinary action in a court of law, they have, I am confident,
done a very considerable amount of work in decreasing the incidence
of rheumatism, because unquestionably children who are dry shod
are less likely to contract the disease and are certainly likely to be
less seriously affected by it.