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INFECTIOUS DISEASES
It was a year during which the wort of the schools was disturbed
not by an outbreak of serious infection, but by action to
prevent such an occurrence. Experience having shown that Salk
vaccine for protection against poliomyelitis is safe, every
effort was made to vaccinate all the children for whom consent
bad been obtained before the end of the school summer term, This
would have been impossible to achieve, except through the
schools and the help given hy all concerned is greatly appreciated.
Sonne dysentery, which had been absent from the borough for
many months, returned towards the end of the year mainly in the
South Croydon area. It responded to the usual methods of control
in this part of the borough, but elsewhere, it was tending to
become endemic at the close of year.
Findings at Routine Medical Inspections.
The figures shown in Appendix B, Table V, follow the usual
pattern. I have included a table giving details of children
noted at inspection as having had an operation for removal of
tonsils and adenoids. This information was collected last year
at the special request of the Ministry of Education, who reviewed
the findings for the country as a whole. The conclusion
to which one is forced by the large variation this revealed between
different local education authority areas is that the need
varies with the availability of facilities for the operation. It
requires much persistance and courage to await the shrinkage of
naso-pharyngeal lymphoid tissue, which generally takes place
*hen children reach the age of puberty. The role of the School
Health service has been to explain to parents what is taking
Place when children meet at school for the first time new infections
and to recommend deferment of operation in the absence
if any complications. This has now become the policy of family
doctors and Ear, Nose and Throat Specialists and it is perhaps
one occasion when long waiting lists may be an advantage to
those thus forced to wait. It might be argued that a minor
operation, which can do no harm is surely justified, even if it
"V do little good. It is, however, a fallacy that the operation
for removal of tonsils and adenoids is entirely free from risk.
One Croydon child died last year while being anaesthetised for
this operation, and 32 other deaths in England and sales were
recorded in 1958 as associated with the operation for removal of
tonsils and adenoids.