View report page

35
Children suffering from scabies and impetigo are treated at the bathing centres.
The total of such cases was 8,389 for the year, a considerable increase on the number
for the previous year (6,435).
Co-operation with the medical officers of the City of London and the metropolitan
boroughs in remedying verminous conditions in the homes of children has been
continued.
The high incidence of scabies which shows further increase gives cause for
concern. The difficulties in dealing with this scourge are great. While school
children can be, and are, inspected, the disease, which is very contagious, affects
older and younger members of the family who cannot be inspected ; and, although
they are offered facilities for treatment by the local sanitary authority, there is no
means, other than persuasion, of ascertaining their condition or of bringing pressure
upon them to take advantage of the facilities. The school children who have been
treated return to homes where other members of the family are untreated and
reinfection is frequent.
The co-operation of the sanitary departments of the Borough Councils in
respect of simultaneous disinfection of homes is gratefully acknowledged.
In view of the increasing incidence of scabies, studies have been made, in three
divisions, of the method by which the disease is spread. These studies are too detailed
for reproduction in full in this part of the report. Dr. A. B. Francklyn has investigated
all the records of children at two bathing centres in Paddington and Kensington
during the years 1934-36. The number of histories investigated was 517. A
summary of the results of the investigation is contained in the following paragraphs.
Girls were in excess of boys in the ratio of 57 to 43. The age incidence shows
the disease mounting to age 6, remaining steady from 6 to 9, and decreasing from
10 onwards.
A case scrutiny of the source of contagion enabled a conclusion to be reached
in about 50 per cent.; of these, were: scabies arising in the home and affecting older
members of the family first, 26 per cent.; the purchase of second-hand clothing,
10 per cent.; playing with friends or relations outside the home who are known to
have had scabies, 6 per cent.; visit on country holiday, hopping, etc., 6 per cent.
Although many schools suffer to a greater degree than others, the evidence of spread
in school is weak and inconclusive.
Spread of disease to separate families living in the same house does occur, but
on analysis affects only a small proportion of the whole. It is not the rule and only
occurs when the relation between the families is closer than usual.
Reinfection of cured children is a very disheartening problem. "Return"
cases amounted to 20 per cent, of the children treated in 1936 at the Paddington
centre. Of the return cases 27 per cent, are reinfected within one month, 30 per
cent, between one and two months, 20 per cent, between two and three months, 11
per cent, between three and four months, 9 per cent, between four and five months
and 2 per cent, between five and six months. Enquiry was made into the probable
source of reinfection, and the following list of causes was drawn up on the information
received:—
(a) Children of family not all treated simultaneously;
(b) Adult members of the family suffering from scabies;
(c) Bedding not disinfected or not disinfected during treatment;
(d) All articles of clothing, woollen toys, etc., not sent for disinfection;
(e) Chronically dirty families;
(f) Irregular attendance at the baths.
Dr. Francklyn draws the following conclusions from her survey : Overcrowding
accounts for only a very small percentage of cases; the schools cannot be held responsible
for any serious increase ; a factor which seems to be at work in the recent
increase of the plague is immigration from certain localities where this disease
appears to be prevalent.
Scabies and
impetigo.