London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1896

[Report of the Medical Officer of Health for London County Council]

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Scarlet fever and elementary schools.
The occurrence of scarlet fever among the pupils of elementary schools is referred to in the
following reports—
Paddington.—Some thirteen cases of scarlet fever having occurred among 656 children
attending the St. Paul's Church Schools, the sanitary authority made an order requiring the school to
be closed for three weeks. The number of cases in the immediate neighbourhood of the schools in
successive periods of three weeks was as follows—6, 6, 9, 13 and 3. The school was closed during the
last period. "There are close on 100 scholars in the school in excess of the accommodation."
Lee.—The medical officer of health states that the number of cases in successive quarters of
the year were 9, 2, 6, 7 and 5. He writes—
Some of those in the first quarter were connected with the outbreak at the Pope-street Board School,
which was entered into fully in my last year's report. Nearly all those in the second quarter were among
children at New Eltham, and the Board school was again the focus of contagion.
Plumstead.—Account is given of six children who were sent home from school by the teachers,
who had observed that the children were desquamating. In two cases the parents were prosecuted, in
one case successfully. The medical officer of health writes " the various teachers who by their
watchfulness were enabled to detect these cases, and so further prevent infection, deserve great credit;
and if similar vigilance were practised by all school teachers, I believe there would be a considerable
reduction in the number of cases of scarlet fever."
Wandsworth.—The following paragraphs appear in the reports of the medical officers of health
of this district.
(Clapham)—The prevention of the spread of scarlet fever is made much more difficult owing to the
very mild type of the disease that has been prevalent. It has frequently occurred that children have
been discovered in a peeling condition in whom the feverish stage had been very short and had not
been noticed by the mother. In other instances it has seemed very probable that the illness had been
concealed wilfully, the parents knowing what was the matter. One instance occurred in Clapham where
information was given me by neighbours, and on visiting the house I found a child in the highly
infectious or peeling stage. I was informed that the mother had stated to a neighbour that she would
not have a doctor because then the other children would be stopped from going to school, and so would
lose a medal. It was not possible, however, to get satisfactory evidence to prove the parents knowledge
of the presence of scarlet fever without which it would be impossible to take proceedings for wilful
exposure. The difficulty here is an illustration of what so frequently occurs and so often prevents
anything being being done to prevent or punish the most reckless exposure.
(WandsUorth)—During the month of March several cases occurred in No. 1 Ward, in children
attending the infant department of the board sc hool there, and there was reason to think that infection
was being spread by a case which had not been notified. I communicated the particulars to the
medical officer of the School Board, suggesting that the infant department of the above school should be
closed for 14 days. He accordingly advised the school to be closed from March 27th to 13th April with
beneficial results.
(Putney )—The report contains reference to the discovery by the teacher of a girls' school of
a child who was attending school while desquamating. The teachers brought the case to the knowledge
of the medical officer ot health, who writes. " Happily I have always found, in the prevention of the
spread of disease, the sanitary authorities have most useful auxiliaries in the teachers of the National
Stoke Newington.—The medical officer of health states that of 220 cases occurring in 166
different houses school attendance was ascribed as the origin of the infection in 41 cases, infection from
a preceding case (apart from school) in 10, and in one case there was strong reason for believing that
infection was re-introduced by a patient dismissed from a fever hospital. One school was closed on
account of this disease for five days. The following paragraphs appear in his report—
As there was a grouping of cases around one of the board schools and the number of cases that had
been attending the school was out of proportion to the numbers that had been attending other schools, I
got the consent of the School Board medical officer to inspect the bulk of the scholars. As a result, three
children presenting suspicious symptoms of mild or delayed scarlet fever were sent home and
It has now been abundantly demonstrated that school attendance is responsible for a considerable
spread of infection during epidemic periods. When are we to reap the fruits of this knowledge and
arrange for frequent and systematic medical inspection of the scholars in the board and other public

holiday influence be compared with the four preceding and four subsequent weeks, the following results are obtained—

Period.Notified cases—Ages.Increase or decrease per cent.
0—33—1313 and upwards.0—33—1313 and upwards.
Four weeks preceding weeks of holiday influence (28th to 31st)2751,681420
Four weeks of holiday influence (32nd to 35th)3481,632496+26-5— 2-9+ 181
Four weeks following weeks of holiday influence (36th to 39th)3501,980369+ 0-6+21-3—256