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48
of breath on exertion The third and fourth children had organic
mitral systolic bruits after 3 and 5 years respectively, but were
able to take part in full games and exercises at school, while in the
fifth child the heart appeared perfectly normal after 18 months and
has remained so for a further two years
"The points in this investigation which 1 would like to
emphasise are that a follow-up of children who have had an acute
sore throat can be organised by public health authorities; that the
diagnosis of early heart disease is to be expected in only about
1 per cent, of the children examined, and that this method of
tackling the disease offers a means of limiting its ravages"
Sore Throat Follow-up Scheme—At Dr Sheldon's request at
the close of the year, a follow-up scheme was begun The parents
of all children reported to the School Medical Service to have had
a sore throat are to be invited in writing to bring the child to the
infectious disease clinic approximately four weeks after the onset
of sore throat
The primary purpose is to make sure that no cardiac complications
have followed the sore throat Only two cases were seen
in 1937, but experience during 1938 suggests that the scheme will
have definite value The parents have proved willing and anxious
to co-operate
The following table shows the work done at the Infectious
Disease Clinic, the large majority of patients being of school age:—
Number of clinics held in connection with Infectious
Diseases and Immunisation 68
Number of attendances made 2,909
Average attendance per session 428
Number of scarlet fever cases discovered 1
Number of diphtheria cases discovered 10
Number of virulence tests taken in diphtheria carriers 49
Number of children recommended to rheumatism clinic 15
Number of children recommended to ear clinic 8
Number of children recommended to orthopaedic clinic 2
Diphtheria Immunisation—Immunisation was carried out
at the weekly clinic on Tuesdays at 3 pm and at Infants' Departments,
along the lines detailed in the previous reports The
following summarises the work done :—
Schick tested for the first time 161
Negative (including pseudo and negative) 65
Positive (including pseudo and positive) 96