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20
Although many of these missed cases appear to have worked no
further mischief in the schools, this has not invariably been the case,
and on more than one occasion small school outbreaks have occurred
which were fortunately checked before reaching larger proportions
by the discovery of a child in the infectious stage in one of the
classes. The most noteworthy of these outbreaks was that which
occurred in connection with Silver Street Board School in the middle
of May. An unusual number of notifications reached me from the
neighbourhood of the school at this time and on making enquiries, I
found that the children affected had attended one of two classes in
the school. I made an inspection of these classes without delay and
found in one of them, in the Infant's Department, a boy who
presented all the appearances of having had a recent attack of the
disease; he was desquamating freely and was evidently beginning
to suffer from kidney complications. On visiting his home the same
morning I found another boy, his elder brother, in a similar condition.
This boy was a member of the other class in which cases were
occurring, and he had attended school fairly regularly up to that
day. Immediate steps were taken to thoroughly disinfect and cleanse
the class rooms, etc., but many of the children had already received
their infection and in all 15 were notified where the illness was directly
traceable to these two missed cases. The outbreak came to a
sudden end within a day or two of their removal.
I questioned the mother of these boys closely concerning their
illness, as the case appeared to me, at first sight, to be one in which
proceedings under the Infectious Disease Notification and Prevention
Acts should be taken, but her answers convinced me that in the
first instance the acute stage of the disease had been very mild, and
consequently difficult to detect, and that her failure to recognise the
later stages was due to ignorance and incapacity for making ordinary
observations.
I have no doubt that a not infrequent cause for the missing of a
considerable number of these milder cases during the past year was
to be found in the straightened circumstances of many of the families
affected. In consequence of this, the medical attendant has been