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19
PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES

During 1948, immunisation was also carried out by private practitioners in respect of 141 children under
the age of 5 years, and 53 children of school age in accordance with the provisions of the National Health
Service Act, 1946.
The approximate mid-year population 1948, as supplied by the Ministry of Health, based on ration
books, was 15,544 under 5 years of age, and 20,663 between 5 and 15 years of age. Since the inception of the
scheme for immunisation until the end of the year 1948, it is estimated that 56 per cent of those under 5 years
and 84 per cent of those between 5 and 15 years had been immunised.
Report on an outbreak of Diphtheria in a School:
On November 30th, 1948, a school child in Class 6 died in Willesden certified as "tonsillitis," but the
cause of death was probably diphtheria. On the same day the child, sitting at the same desk, was notified as
a case of diphtheria due to infection with C. diphtheria gravis.
Between December 3rd and 6th, the class was swabbed, and one nasal carrier was discovered. All
available children were immunised or given booster doses. About this time a case occurred in Class 7. The
contacts in this class were also swabbed, but no carrier was discovered. Dust from the two classrooms was
examined, and C. diphtheria; gravis was isolated. The classrooms were thoroughly cleaned. Two new cases were
notified on December 20th, one from Class 6 and one from Class 2. No carriers were found among the contacts.
During the Christmas holidays, three more cases were notified, which were apparently unconnected
with the outbreak. One was a child who had been absent from school throughout the period of the outbreak;
the second was her brother, and the third a man aged 35 years.
When the school reopened, another case appeared in a boy aged 15 years, again unconnected with the
original cases. Classes 6 and 7 were again swabbed and another nasal carrier was found.
Two weeks later, a case occurred in the nursery class of the school. All the children in this class were
given anti-toxin and a boosting dose was given to those who had previously been immunised in infancy and had
not received boosting doses on entry into the nursery class.