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previously contracted the disease most probably means that the
protection which had been given by the injections of toxoidantitoxin,
while quite adequate against an ordinary outbreak of
diphtheria, was not quite strong enough to protect against the very
virulent type of diphtheria to which these children were exposed
in this outbreak. This view is, perhaps, strengthened by the fact
that of over four thousand children who have been immunised in
Wood Green during the past few years, apart from these eight cases,
only four others have been known to contract diphtheria subsequently.
In no case occurring in an immunised child has the
disease terminated fatally, and during the recent outbreak it was
obvious that the immunised children had on the whole very much
less severe attacks than the non-immunised.
Although immunisation has been offered year by year to all
children in the infant departments of the Wood Green schools for
the past seven years, at the time of this outbreak little more than
twenty-five per cent. of all the children in the three departments
of the Alexandra Schools had been immunised. Towards the end
of the year, when cases were continuing to occur, immunisation
was offered to every child in the school not previously immunised,
and more than half of the children on the roll availed themselves
of the offer. As it happens, there have been no further cases in the
school since this special campaign of immunisation was carried out.
All teachers in the Infants' and Girls' Departments found to be
Schick negative were also immunised.
So far as immunisation generally is concerned, the total number
of children who received full courses of protective injections during
the year was 1,005, and a further 55 were undergoing a course at
the end of the year. 429 children were Schick-tested during the
year. Of these, 269 were children who had been immunised during
1935. 845 children who had received full courses of injections
were awaiting the Schick test at the end of the year.
IX.—OPEN-AIR EDUCATION.
There are no open-air schools in Wood Green, and no open-air
classrooms in any of the elementary schools. The only form of
open-air education enjoyed by the children is the open-air class
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