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1926
19
E. N. aged 30 years was notified on March 16th, and
removed to Hospital on the same day. On admission she had a
characteristic rash on the trunk and limbs together with sore
throat and an injected soft palate. The temperature was raised
for some days. On March 22nd, the skin on the body and hands
began to peel; the peeling was profuse and characteristic. The
case was a typical one of Scarlet Fever in every respect. She
was employed as a packer and sorter at a laundry, and on March
10th, she was sorting the linen, etc. which had been sent from
a house in Hampstead. On March 4th, two cases of Scarlet
Fever were notified from the Hampstead residence, and the
clothes were sent to the laundry on March 8th. The soiled linen,
etc. was supposed to have been disinfected by a trained nurse
and a doctor, but the patient and another girl stated that all the
articles were quite dry and there was no suspicion of any smell
resembling the smell of the ordinary disinfectants in use. I saw
the clothes which were sent to the laundry on March 15th. The
articles were stated to have been "carbonized," which term
probably meant "carbolized." When I saw the articles on March
18th, they were absolutely dry and certainly, neither carbolic
acid nor any of the coal-tar derivants had been used. Nowadays,
in Acton, it is very difficult to state definitely that an adult
patient has not been in contact with some person who might be
in an infectious state, but though strict enquiries were made
E. N. does not seem to have been near an infectious person.
There was no infection among the other workers in the laundry,
in the patient's home, or in the street she lived in. The district
was comparatively free of Scarlet Fever at the time, and no
notification had been received in the first fortnight of March from
any house within a quarter of a mile of the patient's home. The
essential dates were : March 4th, two cases in Hampstead;
March 8th, laundry collected; March 10th, linen sorted by E. N.;
March 12th, initial symptoms of Scarlet Fever in E. N.; March
14th, rash ; and March 16th„ notification.
As far as could be ascertained, the linen was the only
source of infection. In Scarlet Fever, inquiries are made concerning
the movements not only of recent cases of Scarlet Fever,
but also of persons who have recovered from the acute attack.
Cases of Scarlet Fever occur, and the only sources of infection
which can be traced are persons who have previously suffered
from Scarlet Fever and have remained intermittently infectious
lor a prolonged period. This condition is not very uncommon,
and the cases are too numerous for us to regard them merely as
coincidences. I gave instances in a former Annual Report of
cases which pointed to a prolonged period of intermittent infection.