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Joint Report by Dr. W. H. Hamer and Dr. T. Henry Jones upon an Epidemic of
Scarlet Fever in London and Surrey due to an Infected Milk Supply,
in June, 1909.
Preliminary history of the outbreak in the affected districts.
On the evening of June 15th Dr. Williamson, Medical Officer of Health of the Epsom Rural
District, wrote to the Acting County Medical Officer of Health of Surrey informing him that 16
cases of scarlet fever had been notified or discovered in Worcester Park on June 14th and 15th, distributed
in 13 houses, all of which oblained their milk supply from one purveyor. Suspecting that
the infection was introduced by milk obtained from a wholesale company in another county, Dr.
Williamson called at the office of the Local Government Board on June 16th in order to give early
information of an outbreak which he thought likely to affect many districts.
On June 16th Dr. Beale Collins, Medical Officer of Health of Kingston-upon-Thames, became
suspicious that a few cases of scarlet fever notified in his district on June 14th, 15th, and 16th were
due to the same wholesale milk supply and wrote to the Medical Officer of Health of the county
from which this supply was drawn. On the same day Dr. Davison, Medical Officer of Health of The
Maidens and Coombe, whose district was also affected, communicated by telephone his suspicions to
the manager of the dairy company concerned, and received from him the assurance that all milk
sent into the district should be pasteurised.
On June 17th, at 8 p.m., Dr. Allan, Medical Officer of Health of the City of Westminster,
informed Sir Shirley Murphy, Medical Officer of Health of the County of London, that he had
heard of several cases of scarlet fever in Westminster occurring among persons obtaining their milk
supply from a particular retail vendor, and that he was investigating the matter.
On the morning of June 18th Sir Shirley Murphy made inquiries as to whether any local
prevalences were manifesting themselves in London, and as to their possible relation to milk supply ;
moreover, the Acting County Medical Officer of Health of Surrey (Dr. Jones) met Dr. Williamson
(Epsom R.D.) and Dr. Davison (Maidens and Coombe) by appointment, in order to discuss with them
the precautions to be taken in the affected dictricts. Upon visiting other districts on the same day
Dr. Jones found that local outbreaks had occurred elsewhere in Surrey which appeared to be due to
the same cause. On the same day (June 18th) the vendor in Westminster mentioned above discontinued
receiving milk from the suspected source ; Dr. Allan (Westminster) had visited the local
London depot from which the supply was distributed, and had communicated by letter with the
secretary of the dairy company in the country; Dr. Beale Collins had also telegraphed to the
manager of the company requesting him to stop his supply of milk to Kingston ; and Dr. Priestley,
Medical Officer of Health of Lambeth, was advised of the occurrence of the outbreak, the local depot
from which the Westminster supply came being in Lambeth.
On the morning of Saturday, June 19th, Dr. Allan reported an increase in the number of
cases in Westminster; Dr. Parkes, Medical Officer of Health of Chelsea, wrote saying that a few
cases had occurred among customers of a Chelsea retailer who obtained milk from the same wholesale
company ; and Dr. Caldwell Smith, Medical Officer of Health of Wandsworth, telephoned that in his
district several cases of scarlet fever had been reported on the round of a retailer who was supplied
by the same company. Thereupon Sir Shirley Murphy, after conference with Dr. Allan, decided to
advise the manager of the company concerned that the sending of milk to London from the country
depot which had furnished the supplies to Chelsea, Westminster and Wandsworth should be suspended.
An appointment was made by telephone with a local manager of the company at a London
railway station, and Dr. Hamer, Medical Officer (General Purposes), and Mr. Dunbar, Veterinary
Inspector, London County Council, proceeded to this station. The local manager placed them in
telephonic communication with the head manager in the country, who, upon the circumstances being
explained to him, at once agreed to stop the entire supply from the implicated depot, and, save for a
few churns of the afternoon's supply which had already left the branch depot, this was done. It was
further arranged that Dr. Hamer and the manager should meet on the same afternoon at the company's
main offices in the country.
On the morning of the same day (Saturday, June 19th) Dr. Jones (Surrey County) visited and conferred
with Dr. Pocklington, Medical Officer of Health of Wimbledon, Dr. Belilios, Medical Officer of
Health of Merton, and Dr. Beale Collins, Medical Officer of Health of Kingston, in whose districts sudden
outbreaks of scarlet fever appeared to be due to the same wholesale milk supply. Dr. Jones also
telephoned to Sir Shirley Murphy (County of London) and Dr. Allan (Westminster). [It may be
mentioned here, though the information was not forthcoming until later, that an outbreak of scarlet
fever due to the same infected supply of milk was in course of development in the county borough of
Croydon. Dr. Meredith Richards, the Medical Officer of Health of Croydon, has supplied particulars
and made a number of suggestions for which the writers of this report are much indebted to him. He
also visited the farm in the country at a later date.] All the information obtainable, both in London
and in Surrey, now pieced together, confirmed the suspicion that the same milk supply was the
infecting agent in the two counties. It had already been arranged that Dr. Jones (Surrey County)
and Dr. Beale Collins (Kingston) should meet the manager of the suspected dairy company at
Kingston in the afternoon (Saturday). Sir Shirley Murphy now arranged by telephone that Dr.
Hamer should attend this conference with a view to meeting the manager at Kingston and to seeing
Drs. Jones and Beale Collins there. Dr. Allan also proceeded to Kingston, but was obliged to leave
before Dr. Hamer's arrival. The secretary of the dairy company came to Kingston, instead of the
manager, and, the information obtained from him all went to show that the milk sent into the
affected districts in London and in Surrey from one particular depot of the company was at fault,
that depot receiving milk from some 31 farms and being one of 10 or 12 similar depots owned
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