London's Pulse: Medical Officer of Health reports 1848-1972

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Leyton 1933

[Report of the Medical Officer of Health for Leyton]

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187
infection by third persons. Again, the school contact may not go to school,
but he is free to play about in the streets and frequent other public places
as much as he chooses. In fact, excluded school contacts enjoy much more
than their usual amount of freedom out-of-doors due to the fact that they
are too much " in the way " when at home.
The only possible reasons for the exclusion of school contacts are:—
(а) That the child might convey infection to school from the infected
home; or
(б) That the child might develop the disease and infect other children
at school.
With regard to (a) that is a relic of epidemiological theory we have grown
out of; and one which is not put into practice in the case of contacts other
than school children. As regards (6) there is no reason to suppose that the
symptoms of onset of infectious disease are less likely to be detected in
the case of a child attending school, or that an infectious child does more
harm in school than "in the street." If both parents and school teachers
were on the look-out for the first symptoms of infection there would be more
chance of illness being detected in its early stage.
The Efficacy of School Exclusion.
As a test of whether the "game is worth the candle," I have investigated
the records for scarlet fever during the year 1932—a year when the
incidence of the disease was relatively low.
The figures for the year were:—
Number of notified cases 309
Number removed to Isolation Hospital 180
Number treated at home 129
Analysis of Secondary Cases.
(i.e., Cases occurring in households in which a previous case had occurred
within a period of six weeks.)

Analysis aof Secondery Case.

(i. e., Case occuring oi house holds oi which a previous case occurred within a period of six weeks.)

No. of days After Primary Case on which Second Case Occurred.Age Groups.
1-556789101112131415 and upwards.
11--1-------1
31--1--------
41----------1
51111---1---2
8----11-----2
11--1--------1
14-----------1
17-----------1
31--1---------
36-------1----