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Prevention Of Spread Of the Disease.—The information obtained in the above enquiry
is useful to prevent further spread. The general procedure may be stated thus :—
Ascertain from teacher or children whether any notified cases showed any symptoms in
school or playground, e.g., languor, drowsiness, headache, sore throat or vomiting. If not,
there is little likelihood of further cases from school infection.
If symptoms were observed, note the names of those sitting next or those who accompanied
the child to or from school. They should be watched for symptoms as suspects.
Exclude all children with sore throat whether scarlatinal symptoms are present or not.
Train the teachers not to re-admit any child to school after absence for indisposition until
the parents have afforded a satisfactory reason for the absence.
Any child absent for sore throat should not be re-admitted except on medical authority.
Examine all suspects for peeling hands and for nasal or aural discharges and exclude from
the playgrounds as well as school all contacts and those suffering from sore throats.
This enquiry, if carefully conducted, does not give rise to scare or alarm, and affords the teachers
a practical insight into a very important matter.
Mode of Spread of Scarlatina.—Illustrative cases of the behaviour of scarlatina are afforded
from enquiries at Broomsleigh-street School, where, although there had been no cases for several months,
a small outbreak began early in 1908, shortly after the Christmas holidays. Twenty cases occurred
closely associated, whilst three fresh cases which could not be traced to school arose in the Easter holiday
and one in the summer term, making 24. Many of these cases could not be traced to the school. A
large proportion of the infected children came from three streets immediately adjoining the school and
partially isolated in the form of a cul-de-sac by the railway. Several were undoubtedly infected out
of school as the result of non-isolation of mild cases. Nine cases, however, occurred in one classroom of
infants, aged five to six years. Fourteen other children who had not had scarlatina were closely associated
and exposed to the risk without presenting any symptoms of disease. A tenth isolated case
occurred in this room, three months later, from home infection.
bchool outbreak of scarlatina, Broomsleigh-street, 1908. Cases not showing any symptoms in school do not
give rise to any secondary school cases.
At the Portland (Girls') School early in September a girl, suffering only from sore throat, infected
two classmates with scarlatina and also her sister at home. The sister again infected three neighbours
Scarlatina and sore throat. " Portland," Sept., 1908. Shows how two sisters gave rise to two series of cases.
The continuous circles are notified cases of scarlatina, dotted circles probable cases not notified. The symptoms
noticed in school are given, and intervals between cases.