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9 of them the onset occurred either on October Ist or 2nd (Tuesday
and Wednesday). The dairyman resided outside the district,
and on inquiries, it was found that in Hammersmith and Chiswick
about 30 cases had occurred in families supplied by the same milk
vendor. The onset of the symptoms in all these cases coincided in
point of time with that of the 9 cases in Acton. An examination of
the employees was made, but no illness resembling scarlet fever
had occurred amongst them.
Inquiries were then directed to the milk supply, and it was
ascertained that the dairyman distributed about 500 gallons each
week day and about 800 gallons on a Sunday. The 500 gallons
were obtained from two farms, but the extra 300 gallons were obtained
from a large distributing company in Paddington.
The Medical Officer of Health for the district in which the two
farms were situated was communicated with, but the milk supply
from these two farms was free from suspicion.
It will be observed, though, from the dates given above, that
Sunday, September 29th, would be the most probable day on which
the infection occurred, and on that day some of the milk was obtained
from the distributing company. The latter company
obtains its milk supply from a large number of farms. The milk was
mixed, and inquiries had to be made at all the farms. These
inquiries were made by the officials of the London County Council
with negative results.
As far as Acton was concerned, I believe that the milk had
absolutely nothing to do with the infection, and that the high
percentage of cases which occurred amongst the customers of this
particular dairyman was a mere coincidence.
Of the 9 cases whose onset of symptoms dated from October
Ist or 2nd, 4 attended Southfield-road School, 3 attended Central
School, and 2 were not of school age. On October IIth, a case
was notified from The Avenue. The skin of the hands and body