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which were harbouring strepto cocci in their throats or noses.
One of the girls was removed to Hospital on the l8th and a
further five girls and one infant on the 19th all having had
sore throats for one or more days before removal. Consideration
was given to the possibility of Dick testing and injecting
Scarlet Fever anti-toxin but the number of children was large
compared with the staff available and the circumstances then
prevailing locally in the matter of air raids prohibited this
course of action. The 138 boys at the Orphanage who had
previously mixed with the girls during the day time were kept
separate and at the suggestion of the Medical Officer to the
Wandle Valley Isolation Hospital it was decided to give the
girls and infants 2 tablets (i.e. gr. 15) each of Sulphonamide-P
daily for 3 days. These tablets were given on the 20th - 22nd
September during which 3 days three more infants and three girls
were admitted, one of the latter being diagnosed clinically and
bacteriologically as a case of diphtheria.
No further cases occurred until the 28th when a member
of the Junior Nursing Staff and one boy commenced with scarlet
fever. A second course of sulphonamide was therefore given
to the girls and infants and a first course to the boys after
which no further cases occurred among the former, but the boys
having one further case on each of the 7th, 9th and 11th October
a second course was given to them and the epidemic ceased.
It is regretted that circumstances marred the observation of
this outbreak and especially that detailed bacteriological
examinations could not be made. While it is appreciated that
without a comparable group who were not treated with Sulphonamide
P. no reliable conclusions can be drawn, the comparatively sudden
cessation of the epidemic after the use of this drug suggests the
desirability of its further trial under similar circumstances.
After a break of 19 days, during which 14 of the
scarlet fever cases but not the case of diphtheria had returned
from the Isolation Hospital, 2 cases of diphtheria occurred
among the girls, followed by a further 2 eases on the 6th
November and one on the 9th November. During this period
regular clinical examinations of the throats were made but very
few swabs were taken and no innoculations given. It is
interesting to consider why this outbreak of diphtheria died
out so quickly and without further cases occurring as only about
10% of this school population had then been immunised or had
suffered from diphtheria previously, whereas, in 1924 no less
than 90 cases of diphtheria occurred in this Institution during
a similar outbreak. Possibly a number of the children carried
the germs for a while without suffering from the disease, but
during the spring of 1941 when general immunisation was being
carried out 34 children were Schick tested Who had previously
had diphtheria or been immunised and of these 3 were still
Schick positive suggesting that at least some of the
susceptible were not attacked although presumably exposed to
infection. '
ERYSIPELAS.
There were 17 notifications of erysipelas during the
year as compared with 10, 13 and 14 in the last three years.
Of these 7 were patients in the Mental Hospitals, the remaining
10 being unconnected cases scattered over the District. Four
cases were admitted to the Isolation Hospital. No deaths
occurred.
PUERPERAL PYREXIA.
Two cases were notified as compared with 3 last year.
Both cases were admitted to the Wandle Valley Joint Hospital
where they recovered.