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113
Parish of Wandsworth.
over 800 scholars, was excluded as the cause of the
disease, but the national school was closed on my instructions
on March 5th for fourteen days, with the
almost immediate effect of checking the outbreak.
After that date six notifications were received, only one
of these from a household not previously infected. This
child had been to school on March 5th, the first symptoms
appearing on the 7th. The other five were
secondary cases. Out of the twenty-three households
infected in only six were there any sanitary defects, and
these were of a minor character. In four the connexion
between the water-closet and the drains was defective.
In this outbreak it was at first difficult to arrive at
a definite conclusion as to its causation, owing to delay
in notification of the cases. In four of the cases no
medical man was called in until some time had elapsed,
and children from the infected households were meanwhile
attending school. In one or two cases there was
difficulty in diagnosis as some of the attacks were mild
and not well-marked, whereas others were of a severe
and virulent type. The fact that the outbreak was
checked by the closure of the school affords strong
grounds for the belief that, at any rate in the later cases,
the infection was received at school, principally at
Sunday-school, where the same control is not possible as
far as overcrowding is concerned.
The outbreak in Ward 3 was of a very malignant
character, and this was specially marked in the primary
cases. This outbreak was limited to children attending
one school, and the infection was traced to the attendance
of a child suffering from the disease at school on
the afternoon of March 2nd. For some months previous
to this no cases had occurred in this neighbourhood, and
the school had always remained very free from diseases
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