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

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London County Council 1900

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

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24
and that the malady then spread within the school. Six cases also occurred in a mixed day and
boarding school in that district, the first case occurring in a day scholar. The medical officer of
health of the Strand mentions an outbreak in connection with a police section-house, and the
medical officer of health of Westminster calls attention to the special incidence of scarlet fever on
the populations of Government buildings, chiefly in barracks or married soldiers' quarters. In
St. Saviour's district the medical officer of health states—Christchurch Schools were closed
for a fortnfight owing to the prevalence of the disease amongst the younger scholars. This
closure was effectual in putting a stop to the disease."
As in previous reports, I have shown in diagram XI. the number of cases of scarlet
fever appearing in each weekly notification list, in relation to the mean of the year, in 'three
age groups, 0—3, 3—13, and 13 years and upwards, these age groups representing approximately
the pre-school age, school age and post-school age. The summer holiday of the London School
Board schools began in 1900 on Thursday, the 20th July, i.e., the latter part of the 30th week,
and the schools re-opened on Monday, the 27th August, i.e., at the beginning of the 35th week.
If the number of cases notified in the four weeks, which would be most subject to holiday
influence, be compared with the number of cases notified in the four preceding and four
subsequent weeks, the results shown in the following table are obtained. It will be seen that,
the decrease during the period of holiday influence is most marked at ages 0—3 and 3—13, and
the increase subsequent to the period of holiday influence is particularly marked at the school
age.

Scarlet fever—Notified cases,1900.

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)108607202
Four weeks of holiday influence (32nd to 35th)90512182—16.7— 15.7— 9.9
Four weeks following weeks of holiday influence (36th to 39th)108865263+ 20.0+ 68.9+ 44.5

Scarlet fever, 1900—Proportion of eases and deaths in hospitals.
It will be seen by reference to diagram IX. that there was in 1900 a slight increase in
the proportion of the notified cases admitted to the hospitals of the Metropolitan Asylums
Board, and a slight decrease in the proportion of deaths occurring in those institutions compared
with the proportions in the preceding year.
Return cases.
The occurrence of "return cases" of scarlet fever is mentioned in a number of the
reports of medical officers of health. In Paddingtou fifteen such cases were noted by the
medical officer of health; in Kensington, one case; in Fulham, seven cases; in St. George,
Hanover-square, two cases; in Stoke Newington, three cases; in Shoreditch, one case; in
Battersea, thirteen cases occurred after the return of a patient who had suffered from scarlet fever,
one after a patient had suffered from diphtheria, and two in which cases of diphtheria followed
the return of patients who had suffered from scarlet fever. In some of these cases the interval
between the return of the first patient and the occurrence of others was prolonged. In Wandsworth.
parish three cases occurred, and in Plumstead nine cases. In the above statement where
oi\e or more persons appear to have been infected by the patient who had returned, they are
included in the total as a single case. It is interesting to note that some of these cases occurred
after the retention in the hospital for a considerable period of the patient, who was believed to
have returned home in an infective condition; in one instance this period was sixteen weeks.
Scarlet fever—Age and sex distribution.
The following table shows the case-rates, death-rates, and fatality of scarlet fever during
the year 1900. The case-rate was practically the same among males at all ages as that among
females, but the death-rate and fatality were higher among males than among females. In the
age groups adopted for the purposes of the table the greatest incidence of attack was upon both
males and females of four years of age. The greatest incidence of death was upon males of
four years of age and upon females of two and three years of age. The fatality was greatest
among males under one year, and among females of one year of age.