View report page

It will be seen from the foregoing table that the scarlet fever death-rate in the period 1901-3 was
highest in Bermondsey (0.22) and lowest in Woolwich (0.05), and in the year 1904 was highest in
Finsbury (0.17) and lowest in Holborn, where no death was recorded. The scarlet fever death-rates
obtaining in London during the four quarters of the year 1904 were as follows :—First quarter, 0.07;
second quarter, 0 07 ; third quarter, 0'08 ; and fourth quarter, 010 per 1,000 persons living.
With the continuance of diminished prevalence and of diminished severity of cases of scarlet fever
occurring in London, the discovery of the source of infection in particular instances was especially difficult.
Dr. Newman found it possible to trace to their probable source of infection 50 cases out of 148 occurring
in Finsbury in the first six months of the year. Dr. Brown was able to attribute 53 cases out of 454
notified in Bermondsey to the following causes—Previous case in house or family 31, to friends (visitors 5,)
o return cases 15, to playmates 2. In Battersea, of 385 cases notified, Dr. McCleary found in 78 cases a
history of direct personal contact with a previous case in the district, while in 14 others infection occurred
outside the district. Dr. Stevens comments on the exceptionally large number of cases in Camberwell,
which must have been contracted from other children who had been playing about in the streets
while suffering from a mild and unsuspected attack of the disease. No outbreak due to milk is
recorded during the year.
The following occurrences are notified in the annual reports—In Paddington there
was an exceptional prevalence of this disease in August and September, all but four of 51 cases
occurring in a comparatively small area of the district, and due to delay in the notification
and, consequently, in the isolation of the earlier cases. In Chelsea 12 cases occurred between
28th October and lGth December among children attending the Oratory School. In Hampstead
a number of cases occurred among children attending the Emanuel Schools, Mill-lane, which in
consequence were closed for three weeks in October. Dr. Newman comments on a higher incidence
of scarlet fever in Finsbury on children of the school age. Of 148 cases occurring in the first six months
of the year, 19 were traced with some degree of probability to infection connected with school attendance,
but in only six was there evidence of infection by previous cases or contacts attending the same class;
the remaining 13 cases must have contracted infection in the playground or precincts of the school. Of
the six referred to, one child was probably infected by a class mate, but " che remaining five cases were
indirectly infected by third persons who carried the disease without themselves acquiring it. Of these
five children who acted as carriers of infection, three had never had scarlet fever, and yet were not
attacked.'' The child probably infected by a class mate continued to attend school for four weeks
1 See footnote (') page 7.