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48. It was shown that although there is a very great difference
between schools as to the amount of infectious disease incidence,
a high notification rate may be altogether independent of any
special conditions of the school, and may be consistent with an
average amount of infectious disease in the neighbourhood, and
with a low mortality.
A school may have a high incidence because the children
attending it have escaped exposure to infection to an exceptional
degree before commencing their school education, and are consequently
less protected lay a previous attack than children at
other schools. This factor probably accounts to a large extent for
schools in good class neighbourhoods having a higher incidence
than those in poor crowded districts. We find that although the
school incidence rates are much higher in the better class districts,
the district rates are more nearly equal.
It was further seen that the only conditions affecting the London
County Council Schools, which are variable and likely to influence
the prevalence of infection, are the amount of air space and
the maintenance of ventilation, and ability and energy in
detecting early cases of infectious disease, and excluding the
same; and that there is reason to think that the importance of
these measures is generally realised by teachers.
It was noted that there was a great reduction in school
incidence during the past five years, as compared with the
previous quinquennium, and that the reduction is especially
marked at the schools which had the higheat incidence during
the first five years. It was satisfactory to find, from the Registrar
General's Annual Returns, that the scarlet fever and diphtheria
death-rates in Woolwich were much less than in London during
the five years. Of the ten South Eastern Boroughs, only one—
Greenwich, had a lower scarlet fever mortality than Woolwich.