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34
Scarlet Fever. 420 cases were notified, giving an attack rate of
6-31 per thousand. 211, 68 and 155 cases were notified in 1912-11-10. The
patients were distributed amongst 340 houses and 124 streets. One case
occurred in 283 houses; two cases occurred in 41 houses; three cases in
10 houses; four in five houses; five cases in one house. The removals to
hospitals numbered 388, an isolation percentage of 92.8There was one death,
giving a fatality of 0.24 per cent. of cases notified, and a death-rate of 0.15 per
1,000 of the population. Besides, nine cases were notified from the Edmonton
Infirmary, who were not Edmonton residents, but were treated in our
Hospital. There were no duplicated notifications, but one case of infection
mixed with diphtheria.
Secondary cases numbered 61 out of 420 (excluding nine cases from
Edmonton Workhouse).
In March there were 39 cases; the school most affected was Silver Street
and the southern Sunday Schools, excepting St. John's. In the last four months
of the year cases were unusually numerous as in the neighbouring County of
London and most of its suburbs. It was the worst outbreak since 1906. It
affected all the schools.
The fever was, however, of a mild type and its mildness was a reason for
the unusual spread of the disease, because, if the children had had more serious
symptoms, the parents would have been more careful to prevent the spread of
infection.
There were 22 cases notified where subsequent observation did not confirm
the diagnosis; they are not included in the above figures.
Return Cases—See section on " Hospitals."
Scarlet Fever Outbreak at the Workhouse and Infirmary —
The first case was an Enfield child who was admitted on March 4th, and
showed a rash 9 days later. Sixteen further cases followed. Notification was
received of the first case on March 20th, and of the last case on April 24th. The
contract for milk supply had terminated on the 31st March, and a new one
entered into after that date with a fresh contractor. This I might say was not
in consequence of the outbreak, but an ordinary business transaction. On
April 7th, I visited Dr. Mort, medical superintendent, to discuss the circumstances,
and I advised him to recommend to the Guardians the installation of a
milk steriliser and a food refrigerator, which appliances have now been
provided. I think that they should be established in all large public
institutions, especially where the population consists to any extent of young
children. I made special enquiries also into the source of the milk supply up
to the 31st March, which were continued by the Medical Officer of Health ef