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37
Again, there is 110 doubt that many mild cases of both Scarlet
Fever and Diphtheria are never notified, and naturally there
would would be more unnotified cases in a poor district than in
a well-to-do one.
There are thus, it is seen, several considerations quite apart
from school influence which would cause one school to have a
higher incidence than another.
50. School conditions may, and no doubt do, affect the spread
of infection in certain ways. The drainage and general structure
of buildings of the permanent Provided Schools may be taken
as equally satisfactory at all of them. The drains at these schools
are tested every year and flushed several times a year. There are
few, if any, open manholes in the vicinity of any schools, and
none I believe near Ancona Road School. Cubic and square
space are the same at all the schools.
All these matters may, therefore, be disregarded in considering
why one school has more infectious disease than another.
Ventilation of class-rooms is, at most schools, of the natural
kind by open windows, and is therefore necessarily variable ; it
depends both on the head mistress's vigilance and on the predilection
of each individual teacher. At a school recently visited
the air in three class-rooms was found perfectly sweet; in two,
decidedly close.
Lastly, school infection must be markedly affected by the
diligence with which school teachers watch for and exclude
children showing the early indications of infectious disease;
some teachers I have found not only diligent in this way but
particularly talented in diagnosing the signs of infection.
All teachers, however, cannot be so gifted. The London
County Council has laid down strict regulations on these matters,
and my enquiries show that teachers generally recognise the
importance of both these means of preventing infection, viz.,
ventilation, and early detection and exclusion of infective children.