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Analysis sheet of measles outbreak at St. George's-row.—Insufficient knowledge of the conditions prevented
closure in time to stop extension.
SCARLET FEVER.
Whilst the enquiries into the natural history of measles and also of diphtheria have furnished
important and practical means of dealing with these diseases and effected a great diminution in unnecessary
loss of school attendance, scarlatina has not furnished the return which it is hoped will yet be
obtained. We have ascertained that the peeling stage of scarlet fever is of little importance as regards
infectivity and also that a high proportion of people escape the disease. The manner of outbreak in
school, each case usually in a different class, and the difficulty of tracing direct effects of cases, point to
the want of immunity in certain individuals as the most important factor in the appearance of any case.
What the nature of this immunity in the general population is, and its absence in particular cases, will
have to be traced later. School, we can say, is not the most important factor in scarlatinal dissemination.
The enquiry which was being made by Dr. Stevenson, who has now become County Medical Officer for
Schools in Somersetshire, has been continued by Dr. Hogarth. With the co-operation of the Medical
Officers of Health in Battersea, Hampstead, Finsbury and Paddington, detailed enquiries are being
carried out in those districts, as well as in certain other groups of schools when opportunity offers.
The notification forms from head teachers of all schools are considered daily, and when more than one
or two cases occur in a department, the returns are set out on an analysis sheet for the school, and a
watch is kept on the distribution of any future cases.