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Scarlet Fever.—During the year the Metropolitan Borough Councils and the Metropolitan
Asylums Board were called upon to deal with the biggest epidemic of scarlet fever known in the
history of the Board.
The disease became prevalent in the month of July, and a few days subsequent to the re-opening
of the elementary schools after the summer holidays a very rapid rise took place and continued
throughout the Metropolis until the 23rd November, when there were no fewer than 5,664 scarlet
fever patients in the Board's hospitals. During this outbreak of scarlet fever there was a large
number of diphtheria cases notified, with the result that on November 23rd there were 8,669
patients in the Metropolitan Asylums Board Hospitals, or 1,511 more than the highest number
previously recorded.
There were 617 cases of scarlet fever notified in Kensington in 1920. The number of
notifications in the three previous years was 158, 234 and 260.
The following table shows the number of cases notified in each four-weekly period during the
year, and indicates those parts of the Borough most affected by the epidemic.

During the epidemic the Metropolitan Asylums Board were able to remove the vast majority
of patients to hospital at once but, at the busiest times, a little delay did take place in moving
some of the cases. Of the 617 Kensington cases, 538 were removed to hospital and no case the
Board were asked to receive was refused admission.
Although the epidemic was extensive, the cases were generally mild in character and the
extent of the outbreak was very largely due to this characteristic. The children affected were, in
some cases, so slightly indisposed that they were not kept in bed; they were not always kept away
from school and frequently there was no thought of calling in a doctor. These mild cases are just