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Outbreak of Scarlet Fever at the Home for Little Boys, Clapham Park, S. W.—This outbreak
calls for special comment. It commenced in June, and the general incidence may conveniently be
divided into three groups, as follows :—
Group I. 8 children attacked between 23rd June and 2nd August and two recurrent
cases.
Group II. 2 children attacked between 30th September and 5th December.
Group III. 2 members of the staff attacked between 14th and 30th December.
With regard to Group I. three cases occurred on the same day, viz., 23rd June, and one
followed two days later. This outbreak was fully investigated and the conclusion was arrived at that
the cases were attributable to two children returned from hospital after having suffered from scarlet
fever, and who were presumably still capable of transmitting infection. These two children were sent
back to hospital. The remaining four cases in the first group occurred on 5th, 7th and 28th July and
2nd August. Investigations were made but no definite common source of infection could be discovered.
In view, however, of the extreme mildness of the cases it is probable that they were infected by
other children who may "have suffered slight unrecognised attacks at an earlier period of the outbreak.
This assumption is strengthened by the experience throughout London during the recent general
prevalence, in which the disease has been notable for the mildness of the great proportion of cases.
The two cases comprising Group II occurred on the 30th September and 5th December respectively,
and had no connection the one with the other. The source of infection in each of these cases
was most probably the Lyham-roaa L.C.C. school where a number of cases of scarlet fever had
occurred. It may be mentioned that in one case (H.S.) the child was sent to Belgrave Hospital on
5th December for a minor operation and that when he left the Home he was apparently well. On
arriving at the hospital, however, he was found, upon examination, to have a very faint rash on the
body. He was notified forthwith as a case of scarlet fever and removed to the Fever Hospital
direct from the hospital.
The third group of cases affected two members of the nursing staff. As a result of
exhaustive enquiries, it was concluded that in both cases the disease was most probably contracted
from outside sources.
Infectious
diseases in
places of
detention.
In view of the class of the population from which the children admitted to the Places of Detention
are derived there is necessarily a considerable incidence of infectious diseases at these institutions.
Skin and eye diseases, e.g. infective conjunctivitis, impetigo, ringworm, scabies, &c., which are mainly
due to neglect and uncleanliness, are of frequent occurrence. It is necessary, therefore, that proper
arrangements should be made for effectively isolating cases of infectious disease as they arise, and
also for the segregation of all contacts in appropriate groups, if serious disorganisation in the working
of the institutions and the spread of infection are to be avoided. In February, 1913, Ponton Road
Place of Detention was opened for the accommodation mainly of younger children, the building