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of the free milk and meals that the Council is providing
to-day, for there is no doubt that much of the anaemia
in women is due to a lifetime of malnutrition.
The investigations which were commenced in 1937
have largely been continued in 1938.
Work on scarlet fever has been considerably hampered
by the fact that the incidence during the first eight
months of the year was particularly low. Throughout
the latter third of the year, as would be expected,
scarlet fever being regarded as an autumn fever, there
has been a rise in the number of cases, amounting
almost to a mild epidemic. This sudden rise coincided
with the end of the school holidays.
Bacteriologically it was found that there were actually
two waves of infection, the first of which was foreshadowed
in May and June, when cases of infection by
Type 1 Str. pyogenes, which had so far been relatively
uncommon in Barking, began to appear in increasing
numbers, reaching a maximum in September, when
85 per cent, of the cases were due to this type.
In October cases of infection by Type 13 Str. pyogenes
started to occur; previously this type also had
appeared only rarely. In November, 70 per cent, of
the cases were due to this type, whilst the number of
Type 1 cases had dropped to 24 per cent. It is very
noticeable that when the cases of streptococcal infection
are few and sporadic a wide variety of types of Str.
pyogenes is represented: during an epidemic there
is one main type and only occasional others.
The situation at the close of 1938 is that both waves
of infection are dying down, the second more rapidly
than the first, and that the percentage of sporadic
cases is increasing. The cases of both types have been