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18
time to the period when the milk was infectious. The source of
infection of the cows could not be ascertained. Many of the patients
who were infected were admitted to the Borough Hospital, and one
therefore had an opportunity of studying the nature of the malady.
Briefly, it may be stated that the symptoms were indistinguishable from
those of ordinary attacks of scarlet fever. It was, however, noted that
there was not that disposition to spread from person to person in the
infected houses that one usually observes with scarlet fever of human
origin. Thus, of the 28 cases in Croydon eight occurred in four
houses. Of these eight it would-seem probable that the infection was
due to a common origin, having regard to the dates of onset—(house
A, onset June 17th and 18th; house B, onset June 17th and
17th; house C, onset June 16th and 17th; house D, onset June 17th
and 18th). Apart from these duplicate cases there were no multiple
attacks, and this is all the more striking because there was a considerable
number of young persons living in the invaded houses who had
not previously suffered from the disease. The exact figures were as
follows :—
Number of invaded houses 24
Number of scarlet fever patients 28
Total inhabitants of infected houses (exclusive of the
28 patients) 100
Of the total inhabitants (exclusive of the 28 patients), 17 are
stated to have previously had scarlet fever, 73 are stated not to have
had scarlet fever, and concerning the remaining 10 information could
not be obtained. The ages of the persons living in infected houses
who did not develop scarlet fever were as follows :—
0—5. 5—10. 10—15. 15—20. 20 & upwards.
11 10 8 6 65
(One of whom (16 of whom are
19 said to have stated to have
been previously been previously
attacked). attacked).
The incidence of scarlet fever varies with the social status of
the district, and it is doubtless due in part to the considerable increase
of the proportion of smaller tenements that we must ascribe the
increased incidence of the disease during the last few years. In
order to test this theory, I have investigated the proportion of fatal
and non-fatal attacks occurring in various sized houses in the
borough during the last four years.