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school children after discharge from the Isolation Hospital or
from Home Nursing. Exclusion from school is rigidly enforced
until all fear from infection has disappeared.
A total of 783 swabs were taken from suspicious throats and
noses at the School Clinics alone.
The incidence of the various infectious diseases amongst school
children during the last quinquennium is reviewed below:—
(a) Smallpox.—This disease first appeared late in 1929, and
although 10 cases were notified only 1 occurred in a child of
school age.
Unfortunately during 1930 the picture was very different, for a
total of 72 cases occurred amongst children of school age. The
maximum incidence was during July and August when 13 and 17
cases were notified respectively.
Typical examples of ' 'school outbreaks'' were as follows:—
(1) Forest Road Infants' School.—A boy of 5 years of age was
brought to the School Clinic on 4th July, 1930, for "Spots" which
the Assistant Medical Officer diagnosed as Smallpox. The school
was immediately visited and lists of vaccinated and unvaccinated
children were made out. For a period of three weeks all unvaccinated
absentees were visited by the Sanitary Staff who brought three
further cases to notice, and which would probably have been
otherwise missed. All were contemporary infections at the same
class and had obviously been infected at school by a "missed"
case. Repeated examination of every child at school failed to
find this infecting source or any further missed cases. Secondary
cases amongst contacts amounted to 18, of whom 9 were school
children. The last case of this "group infection" was found on
6th September, although the actual school involved had been
released from suspicion by the end of July.
(2) Gamuel Road Boys'' School.—A boy aged 10 years was notified
on 7th September, 1930, by his Doctor to be suffering from Smallpox
and on enquiry was found to have attended school in an infectious
condition. The same routine with regard to the visiting of
unvaccinated absentees from school was carried out, but the visiting
in this instance was carried out (through the kind co-operation of
the Superintendent School Attendance Officer) by the Attendance
Officer for the School. This Officer reported all absentees away
with suspicious symptoms and these cases were at once visited by the
School Medical Officer, and excluded from school until released
from observation. By this system two further cases were discovered
and the school was ' 'cleared'' in three weeks, repeated examinations
of all children at school being carried out in order to detect missed
cases.