View report page

69
SCARLET FEVER.

The 1937 numbers show an advance on those of 1936, when 98
cases of Scarlet Fever were reported. During the whole year the
Isolation Hospital was busy admitting Scarlet Fever cases—usually
in the summer cases of Scarlet Fever diminish to an odd case now
and then, but in the summer of 1937 cases continued to come
fairly steadily into Hospital. The cases were not severe in type,
and as the distribution shows were drawn from all parts of the
Borough.
111 Scarlet Fever patients and 163 contacts were examined
at the office before returning to school.
We abandoned the practice of excluding contacts from
school attendance many years ago, and we have found no grounds
for changing our present procedure. The contacts are kept under
observation, and if no suspicious symptoms arise, the.children are
allowed to attend school. The contacts are under the observation
at the class teachers and if necessary they are seen either by the
school Medical Officers or the School Nurse.
All the recent investigations tend to prove that exclusion of
contacts is unnecessary. The practice was based on the supposition
that the contacts were potential carriers of the disease, and that it
was necessary to isolate these possible carriers for a period of a
week or a fortnight. We have seen no bad effect from the practice
of allowing contacts to attend as soon as the case is removed to
hospital, and in any event, in an urban area isolation of all carriers,
whether Scarlet Fever or Diphtheria, is impossible. Even when the
contacts were excluded from school, it was never attempted to keep
a healthy child confined to the house, much less to a single room,
Apart from that, there is no evidence that the contacts of Scarlet
fever are more frequently carriers of haemolytic streptococci than
the rest of the community.