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95
The distribution of the cases notified during the period when
the disease was prevalent is as follows:—
September 14
October 7
November 5
December 1
Origin of the Outbreak.
The origin of the outbreak is, of course, difficult to prove,
but there is strong evidence pointing to the disease having been
introduced from without by one of the pupils after her return
to the school after the summer vacation.
Alice D—is the child to which most suspicion attaches.
At the break-up of the school for the summer holidays, on the
5th July, she returned to her home, a flat in a block of dwellings
in Westminster. While she was home she complained of a sore
throat for which she was not medically attended. On the 28th
August she was noticed to have swollen glands, and it was thought
advisable to isolate her for a week, but no bacteriological examination
was then made.
On the other cases coming to light attention was drawn to
Alice D—, and a swab taken from her throat was found to
be positive on bacteriological examination, and she was with the
other patients at once isolated.
Alice D-returned to her home, in Westminster, at the
break-up for the summer vacation on the 5th July. While at
home she suffered from a sore throat, but was not medically
attended at the time; but before her return to school she was seen
by a doctor who found her apparently well. She was the only
member of her family, it is said, who complained of illness while
she was at home. On the same staircase in this block of flats,
but lower down, a case of scarlet fever was notified on 26th July,
and on a lower floor on 16th July, a boy aged 5 was notified with
diphtheria. Neither of the families in which these two cases
of infectious disease occurred went to the same school, but there