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32
SCARLET FEVER.
The number of cases notified during the year was 174, compared
with 115 in 1937. Of these cases 113 occurred in Original Beckenham
and 61 in West Wickham.
The incidence throughout the year was :—
Original Beckenham :
Jan. Feb. Mar. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec.
6 12 13 9 8 7 6 7 11 11 14 9
West Wickham :
Jan. Feb. Mar. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec.
10 7892 6 1 1 5435

Forty-three cases occurred in the Elementary Schools in
Original Beckenham and 33 in the Elementary Schools in West
Wickham.
There were 156 primary infections and 18 secondary cases
(including 4 return cases). The incidence of secondary cases in
houses where the primary case was removed to Hospital and in
houses where the case was treated at home, showed no appreciable
variation.
Original Beckenham.
The rise in incidence in the later months of the year was not
quite in accordance with expectation. The interval since the last
peak (in 1934), being considerably shorter than has been usual in
the past. The rapid development of certain parts of the Borough
in the last ten years was bound to have some eliect on the periodicity
of outbreaks of infectious disease, and a good many years may
elapse before a regular periodicity again becomes established.
West Wickham.
The high incidence of the previous year was maintained in the
opening months of 1938; thereafter the incidence gradually declined.
Throughout the Borough the disease appeared in a very mild
form, and, as is commonly the case nowadays, in a large number of
the cases, the symptoms were by no means typical. In some instances
the symptoms in the initial case in a house were so slight that it
passed unrecognised, and the true nature of the infection only
became evident when secondary cases occurred.