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London County Council.
SCARLET FEVER IN LONDON.
Report by the Medical Officer as to certain recent local prevalences of Scarlet
Fever in London.
(Printed by order of the Public Health Committee, 20th June, 1901.)
Public Health Department,
8, St. Martin's-place, W.C.,
October, 1901.
On Wednesday afternoon, 1st May, Dr. Bryett, the medical officer of health of Shoreditch,
informed me that he had in the past twenty-four hours received numerous notifications of cases
of scarlet fever in his district, that he had found that the persons affected were mostly supplied
with milk by two vendors, B. in Shoreditch, and A. in Bethnal-green, and that B. derived his
supply from two sources, from a firm of middlemen, Y., and from a middleman, X. He further
stated that he had ascertained from Dr. Bate, the medical officer of health of Bethnal-green, that
there was a simultaneous outbreak of scarlet fever in that district, the milk supplied to the
sufferers being derived from A., who obtained his milk from X.
Dr. Hamer at once called on Mr. X., and inquired as to the sources of milk supply to the
two local vendors. Mr. X. was uncertain as to the details of distribution, and referred Dr. Hamer
to his vanman, who lived in Barnsbury. Dr. Hamer went to Barnsbury, but was unable to find
the man. Later in the evening I accompanied Dr. Hamer to Barnsbury, but we were again
unsuccessful, and it was not till early on the following morning (Thursday, 2nd May), that we
were able to see him. He said he had no exact knowledge as to the source from which the milk
he distributed was derived, but he gave us certain particulars as to six farms, and after seeing
Mr. X., and endeavouring to obtain further information, I wrote the same day to the medical
officers of health of the districts in which five of these farms were situated. Mr. X., the following
day (Friday, 3rd May) supplied me with a list of 38 other farms, the milk of which had been
distributed by him in London, and I later wrote to the county medical officers of health of Staffordshire
and Derbyshire, and to medical officers of health of particular districts in one or two
other counties, asking whether any local distribution of milk from these farms had been accompanied
by the occurrence of scarlet fever. Dr. Hamer made further inquiry of Mr. X.'s
vanman, and saw several of the local vendors in Shoreditch and Bethnal-green, and the medical
officers of health of these districts supplied me with particulars of the cases of scarlet fever
which had occurred. The evidence thus obtained by Friday afternoon, 3rd May, strongly
suggested that the farm most likely to be involved was either that of Mr. M. or that of Mr. X.,
both in Staffordshire. Dr. Hamer visited Mr. M.'s farm on Saturday, the 4th May, and while
there I informed him by telegram that I had received information of the occurrence of cases
of throat illness resembling scarlet fever at Mr. N.'s farm. Moreover, on the morning of the
4th May I informed Mr. X. that milk ought not to be supplied from Mr. N.'s farm, and Mr. X.,
on receipt of my letter, himself visited the farm on Saturday, the 4th May, and stopped the
supply of milk. He subsequently assured me that, with the exception of one churn taken from
that farm on Friday, and distributed in Bethnal-green on Saturday morning, 4th May, no more
milk from this source was distributed by him.
Dr. Hamer, on the 4th May, saw Dr. Freer, the medical officer of health, who had given
me information as to the throat illness on Mr. N.'s farm, and also visited the farm. He found
that Mrs. N. had been attacked on the evening of the 27th April, Mr. N. and his daughter on
the 28th April, and Mr. N.'s son on the 29th April. They were all suffering from sore throat,
and Mrs. N. said she had observed an eruption on her chest and arms on Wednesday, the 1st May.
On Tuesday evening, the 7th May, Dr. Newman, medical officer of health of Finsbury,
informed me that a number of cases of scarlet fever had been notified to him on the morning of
the 7th May, all the patients being supplied with milk by a local vendor named P., of Finsbury,
who obtained his milk from X. I visited Mr. R. at once with him. He was unable to give
any precise information as to the source of the milk he had received, but did not think he had
had N.'s milk. We then called on Mr. X.'s vanman who distributed milk in Finsbury. He
was unable to give any precise information, and also thought he had not recently had N.'s milk
in his van.
On Wednesday morning, the 8th, I called with Dr. Hamer on Mr. X., who informed me
that Mr. R. had been supplied with a churn of N.'s milk on the morning of either the 2nd or 3rd
of May, but almost certainly on the 3rd. Later in the day Dr. Newman told me he had ascertained
from Mr. R. and the vanman that their previous statement was, they believed, erroneous;
that Mr. R. had had a churn of N.'s milk, probably on Friday, the 3rd May, and that he had
supplied three or four gallons to another local vendor. Two members of a family supplied by this
vendor were attacked with scarlet fever. Dr. Newman found that a third vendor, K., two of