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Pneumonia.—There were 199 cases notified—119 notifications were from the West Middlesex
Hospital. Ninety were non-resident in this district.
Malaria.—No cases were notified.

Upon receipt of information of the existence of a case, inquiry is made by a School Nurse to
obtain all necessary facts.
Influenza.—There were 18 deaths from Influenza during the year, the mortality being 0.22
per 1,000 of the population.
Cleansing of Verminous Persons.—Particulars are asked for as to the facilities available
in the district for the cleansing and disinfection of verminous persons and their belongings.
Neither the Education Authority nor the Sanitary Authority possesses a Cleansing Station.
Where application is made, the Health Department undertakes the spraying of rooms for the removal
of bed bugs. Bedding and clothing generally can be disinfected by steam at Mogden Isolation Hospital
TUBERCULOSIS.
I repeat what I said last year, that in my opinion an open-air recovery school is a real need
in this district. It is impossible for those who have not been in close personal contact with open-air
recovery schools to appreciate what an open-air recovery school really means. There is so much
uninformed opinion with regard to what such a school means and does.
The present vogue amongst school Authorities for semi-open-air schools is being used very
largely as a counterblast to the idea of an open-air recovery school. True the additional flow of air
has a definite beneficial effect, even if small. In some of these schools and classrooms the idea of
so much light and air into the classrooms means an intense glare for the pupils working in them,
whereas in the open-air recovery school no attempt is made at working on white surfaces except in
adequate shade.
Moreover, the semi-open-air classrooms, as designed, depend for their efficiency on the hygienic
co-operation of the teachers therein, and I am afraid that until hygiene is taught in the training colleges
as a subject to be lived in school, by Medical Officers who really understand the day to day living
of hygiene; instead of it being simply regarded as an academic subject in which an examination has
to be passed, and for which, nowadays, honours can be obtained, we are not going to get that appreciation
of the value of hygiene which is going to make it impossible, for instance, to see every window
closed in a semi-open-air school, except on the north, with a temperature of 73 outside, and also to
see members of the female staff with their overcoats and fur collars on teaching in a classroom,
what time they expect the children whom they are teaching to be clad in their ordinary indoor
garments.
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