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36
Annual Report of the London County Council, 1910.
Scarlet fever
—Incidence
in relation to
school
attendance.
In connection with the reduction in the number of notified cases during the summer
holiday of the schools it may be stated that the summer holiday of the London County Council
schools began in 1910 on Thursday, the 21st July, i.e., the latter part of the 29th week, and the
schools re-opened on Monday, the 22nd August, i.e., at the beginning of the 34th week.

The mild character of the cases of scarlet fever which occurred in 1910 is referred to in many
of the reports. The difficulty of discovering the source of infection of any particular case is therefore
obvious, the disease, no doubt, being often caused by association with a previous case presenting
inconspicuous or perhaps even no symptoms. Account is given in some of the reports of the proportion
of cases in which it was possible to discover the source of infection. In Kensington, of 258 cases,
inr80 contact with a previous case was traced, 20 were due to school infection, 8 to contact with
persons recently discharged from hospital after an attack of scarlet fever, 5 to contact with persons
who had suffered from attack of scarlet fever which had not been recognised. In St. Marylebone,
of 207 cases, infection was thought to be due to a previous case in the family or in the same house in
27 instances ; at school in 6 instances ; from a previous case in the neighbourhood in 6 instances.
In Hampstead, of 135 notified, in 43 the patient was found to be infected by a previous case. In
Stoke Newington, of 84 cases, the source of infection was believed to be due to an antecedent case in
the house in 5 cases, school attendance in 4 cases, and return case 1 case. In Finsbury, of 126 cases,
22 were due to visiting invaded houses in vicinity, 14 to previous cases in same family, 5 were contracted
in hospital, 4 from associating with infected school-fellows, 2 from attendance at the outpatient
departments of large hospitals. In Bermondsey, of 307 cases, 35 were infected by a previous
case in house, family, or neighbouring houses, 6 at school, and 6 were return cases. In Battersea,
of 439, the majority were found to be due to contact with a previous case. In Woolwich, of
506 cases, the source of infection was believed to be in 58 instances due to previous cases in
the house, in 15 instances to school attendance, in 8 to infection from friends, in 5 to visiting
hospitals.

Multiple
cases.
Thus of 1,475 houses invaded, multiple cases occurred in 197, or 13.4 per cent. In 1909, the
number of houses in which multiple cases occurred was 16 per cent, of the houses invaded in the
districts concerning which the facts were stated in the annual reports. There is little reference in
the reports to the occurrence of any prevalence of scarlet fever as the result of school attendance
during the year 1910, and only in one instance was a department closed and in five instances were
classrooms closed.
Proportion of
cases
admitted to
hospital.
It will be seen from diagram (K) that the proportion of cases of scarlet fever admitted to the
hospitals of the Metropolitan Asylums Board was about the same as in the preceding year, viz., nearly
90 per cent, of the cases notified.