View report page

31
attended the school for the last, time before the fumigation took place, viz., October 3rd. For the next
three months only three cases of scarlet fever occurred in children attending this school. I think in
this case it is clearly evident that the disinfection at least did good, and in the former case it is
interesting to note how the separation of the children for the holidays caused the disease to decrease.
Stoke Newington.—"School attendance was ascribed as the origin of the infection of 27 cases."
Battersea.—"In consequence of an unusually large number of cases of scarlet fever occurring
at St. George's Schools, the same were thoroughly disinfected during the Christmas holidays by the
vestry's staff of disinfectors."
Lee (Eltham.).—The report of the medical officer of health contains the following account of
scarlet fever in children attending the Pope-street Board Schools—
The majority of the cases occurred among the pupils at these schools, or in the residents in houses
where they lived. The number of cases notified among the pupils was in October, 19 ; in November, 12;
in December, 21, or 52 in all. There were, in addition, 7 cases in children who lived in Sidcup parish.
Four cases in pupils occurred in the first week of January, a total of 63 cases. In October I reported
the outbreak to you (the District Board), and suggested that, as it could be distinctly traced to contagion
at the schools, it would be advisable to close them, if the number of infected increased, and to this
yon agreed. Later on I communicated with the School Board authorities at Greenwich, and was
referred by them to Professor W. R. Smith, M.D., their medical officer. He, however, declined to concur
in closing the schools, on the ground that there had not yet been a sufficient number of cases to warrant
the proceeding.

Thus about half the pupils were absent.
Under the circumstances I suggested, with your concurrence, that it would be advisable to extend
the holidays from two to three weeks; and I went to the School Board offices on Victoria-embankment
and had an interview with Professor Smith. He again declined to co-operate, on the ground that it
would be more easy, as a matter of procedure, to close the schools again after the pupils had met than to
prolong the holidays. He, however, promised to make no further objections should there be more cases
later. The fortnight's closure seems to have been sufficient to stop the epidemic, for no fresh case has
been notified among the pupils since January 11th. Still, I venture to think that it would have been
better to prolong the holidays if only to make "assurance doubly sure." There seems to me to be also
a probability that closure earlier would have stopped the outbreak then, as it did when applied to the
infants' school at Eltham two years ago.
Plumstead.—In the early part of the autumn most of the cases were connected with the Bloomfield-road
School. The attention of the medical officer of health was directed to a female pupil whom
the teacher had refused to admit to the school, suspecting her of having scarlet fever. The medical
officer found the child to be desquamating.
An infected milk supply gave rise to an outbreak of scarlet fever in Islington, as many as 125
cases in the sub-district of Holloway being attributable to this cause.
The medical officer of health reports that during the early part of February he noticed unusual
prevalence of scarlatina in the north-east of the parish, and that in nearly every instance the person
attacked had been supplied from one local dairy. He learnt from the medical officer of health of
Hornsey that there was similar prevalence in that district, the milk being supplied to the infected
persons from the same dairy. Inspection of the local dairy showed that it was a clean well-conducted
place of business, and he ascertained that the milk supplied from it was received from seven farms
in Derbyshire and from one in Staffordshire. A meeting of the Public Health Committee of the
Vestry was held on the 11th February, when the medical officer was instructed to inquire into the
state of the farms, and the local vendor was informed that he should cease to supply his milk. Up to the
6th February, the milk of the several farms was not kept separate, but on this date the milk from
each farm was supplied on separate rounds of distribution, and within a few days the chief incidence of
disease was found to be on persons supplied with the milk from three farms. The results.of the inquiry
by the medical officer of health showed that there was history of connection, or probable connection,
between persons engaged in the dairy business of two of these farms, and cases of scarlet fever, this
disease being prevalent in the districts; the third farm, moreover, received milk from a fourth, with
which its own was mixed, this fourth being similarly circumstanced in respect to the connection of its
dairy people with scarlet fever. The medical officer of health points out that in only one rural
district with which he was concerned in his inquiries was the notification of infectious disease
obligatory.
Proceedings for the wilful exposure of a person suffering from scarlet fever were instituted in
Kensington, Fulham, St. Pancras, Strand, Poplar (Poplar and Bromley). In Kensington, owing to
the impossibility of proving the knowledge of the defendant as to the nature of the malady, the
proceedings fell through. In the Fulham, Strand and Poplar cases convictions were obtained. In
the St. Pancras case the magistrate dismissed the summons, as he was not satisfied that at the time
of the exposure the patient was in an infectious condition.
The reports of the medical officers of health with few exceptions discuss the difficulties experienced
in dealing with scarlet fever cases owing to the deficiency of hospital accommodation for this
disease in the latter part of the year. Reference is also made to the occurrence of cases of scarlet fever
in houses shortly after the return to the houses of persons who have been treated for this malady in
hospital.
An interesting table is given in the report of the medical officer of health of Paddington,
showing the number of rooms occupied by invaded families, whether one, two, three, four, or five and
more rooms, and showing whether in each group the number of persons per room was two or less, or
more than two.