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101
[1904
SCARLET FEVER.
The number of cases of this disease which were notified was 1,146, or 297
below the corrected average of the preceding ten years. On only two previous
occasions have the returns been so good as those now recorded, namely in
1900 when there were 1,074 cases, and in 1903 when there were 865. The
attack rate was 3.36 per 1,000 of the population as compared with a decennial
rate of 4.23 per 1,000.
In the County of London 13,438 were notified, and the attack-rate was
2.89 per 1,000 inhabitants, or 0.45 per 1,000 less than in this Borough.
In the Encircling Boroughs 2,729 cases were reported, resulting in an
attack rate of 3.36 per 1,000 of the population, which is identical with the local
rate.
For the returns of the preceding ten years Table XCIII. (page 117) must
be consulted.
Hospital Isolation.—As many as 1,024 cases were removed to Hospital,
or 89.4 per cent. of the known cases, which is the highest percentage
hitherto recorded.
Much has been said and written lately with respect to the isolation of
Scarlet Fever in hospitals, and it has been stated by some observers that it has
had no appreciable effect in the prevention of the disease. This is a startling
statement, and one with which the writer cannot agree; and, indeed, it would
require some very strong facts to convince him that the removal of over a
thousand cases of infection, for the most part from tenement houses, occupied
by numerous children, nearly all susceptible to the disease, has had no effect
on the public weal of this borough. When we are considering this question we
must recollect that coincident with the notification of the infectious diseases,
which gave such an impetus to hospital isolation, came the very stringent application
of the Education Act, in consequence of which children were whipped up
to school by the attendance officers in a manner that, while it has filled the
Schools, has not been to the best interest of the public health, and we should put
to ourselves this query : What would have happened if there had been no isolation
? the answer, of course, can only be based on surmise. Schools have ever
been a fruitful source of infection to scholars, more especially since large
establishments, where sometimes between one and two thousand children
are gathered together, have become general; and frequently cases of Scarlet
Fever have been traced to scholars, who either had returned to school too early
after home treatment, or who, through the ignorance of their parents, in slight
cases had returned while in an infected state.