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12
Outside Schools.
Kenmont Gardens 1
Latimer Road 1
City of London 1
St. Marylebone, Higher Grade 1
Oaklands Road, Hanwell 1
Private Schools 8
A certain amount of doubt exists as to the role which school
attendance plays in the spread of Scarlet Fever, and until we know
more of the etiology of the disease, it is unwise to venture upon any
very definite opinion. Hitherto, two modes have been accepted
whereby the disease is spread. The first is direct infection to other
persons in close contact with the actual sufferer. This mode is easily
appreciated, but it has been taken for granted that the disease may
also be spread in some indirect manner not yet properly understood.
There is hardly a disease concerning which opinions have so materially
changed as Scarlet Fever. It was formerly held that the disease
was not infectious until the skin had commenced to peel, and that it
continued infectious as long as the peeling of the skin lasted. Both
theories have been discarded. Scarlet Fever is infectious from the
commencement of the symptoms, and the condition of the skin is no
criterion of the infectiousness of the patient. It is possible, of course,
that the disease is spread in some indirect manner, but the more
closely the inquiries are made, the less numerous do the indirectly
infected cases become. It is true that the untraced cases constitute
the great majority occurring in urban districts, but it is also probable
that many, if not most of, the untraced cases have been infected
by persons suffering from so mild a form of the disease that the illness
has not been recognised. It is these slight, undetected, or
"missed" cases, as they are called, which are the most effectual promoting
causes of an epidemic, and for this reason mild outbreaks are
the most difficult to meet and dangerous to the public. During the
year we had several instances of these undetected cases, giving rise
to limited outbreaks in different schools.
Between June 2 and July 11, 17 cases of Scarlet Fever occurred
amongst children attending the Central Schools. It was obvious from
the distribution of the disease that the school had something to do