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Scarlet fever is caused by an organism called the haemolytic streptococcus, of which
there are some 30 types. The bacteria are localised in the throat and produce toxins. Scarlet
fever is a disease affecting children chiefly between the ages of one and ten years, and girls
appear to be affected more than boys.
During the last century and the early part of this one, the disease assumed grave
proportions. Between 1890 and 1899 notifications in St. Pancras were in the region of 1,000
a year, and death ensued in 459 cases. In 1893 the number of notifications was 2,465.
The severe type of scarlet fever has seldom occurred in recent years. Of the 145 cases
notified in the borough during 1952, the diagnosis of four was subsequently revised. Of the
141 true cases only six could be classified as other than mild. There was no mortality.
Spread of Infection.—In most of the cases investigated during the year it was difficult
to ascertain the source of infection. Where information was available the disease seemed to
be caused by direct contact with another sufferer within the home or at school.
In the past, epidemics have been recorded where the infection was milk-borne. Such
outbreaks involved a series of houses served by the same dairy. There were no such outbreaks
in the Borough during 1952. Constant attention to cleanliness and hygiene in milk processing,
together with 100 per cent. pasteurisation of milk, in London, have almost eliminated this risk.
At one time it was largely believed that infection could be spread by articles which
had been in close contact with the patient. The theory to-day is that it is spread from person
to person.

Place of Treatment.—Ninety-two cases were treated at home. Forty-nine were removed
to hospital, remaining there for a period of 10-21 days, except in two cases, when the period
of detention was 6 weeks and 8 weeks respectively, due to the onset of complications.
Removal to hospital took place for a variety of reasons. In one case there was kidney
trouble, in two cases a member of the family was employed in the catering industry or in school
maintenance, and in three cases the mother was the child's only attendant, and had to go to
work. In the other cases, the reason was lack of proper home isolation mainly due to inadequate
accommodation.
Complications.—In one case, as stated, there was kidney trouble, in one case measles,
whilst in the two cases where treatment in hospital was prolonged, one was complicated by
otitis media and septic spots, and the other by angular stomatitis, rhinorrhoea and septic spots.
Where the patient was nursed at home no complications are known to have occurred.