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25
weeks from his discharge from the Hospital, J. B. attended the
Beaumont Park School. The two "babies" class-rooms at
Beaumont Park are situated in that part of the school farthest from
the Girl's Department, and the entrances to the two rooms are nearly
opposite each other. Between October 27th and November gth,
four children from the same class-room as J. B. were notified of
Scarlet Fever, and in the other class room the same number of cases
was notified during the same period. All the children in these two
class-rooms were examined on several occasions, but there was no
suspicion of a "missed" case. It was noticed that J. B. had a
slight discharge from his nose, but no abrasion of the mucous
membrane. On November 9th, it was decided to exclude him from
school, and the only case that occurred after J. B.'s exclusion was
notified on November 21st, but this case was probably infected at
home, as two cases had been removed from the same house on
November 2nd, and a third on November 4th.
J. B. was kept out of school until the end of the year, and the
parents have been advised to have the child's adenoids removed
before he resumes school attendance.
We have so far dealt mainly with infection as it occurs in the
school, but the same factors operate in the home.
The number of children exposed under the latter conditions is
smaller, and possibly the infection may be more diluted. We shall
deal with the spread of infection in the home under three heads:—
1. Multiple cases occurring probably as a result of infection
from previous cases in the house.
2. Cases occurring in a house within a definite period of
the discharge of another member of the family from the
hospital.
3. Cases recurring in houses after prolonged periods.
It will be convenient when dealing with the first group of cases
to adopt some fixed period. The incubation period of Scarlet Fever
is stated to be from one to seven days. For various reasons it is
advisable not to take so short a period. If we took from the
exposure to infection to the time when symptoms were first exhibited
ye might be justified in limiting the time to one week. But it is