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86
During the five-year period 1925-29, when routine steam disinfection
was practised, the percentage of secondary cases of scarlet
fever from infected households was 6.08 per cent., compared with
a rate of 5.51 per cent, during the five-year period since 1930,
when steam disinfection was abandoned.
Supervision of Contacts.
There must be few areas in which any restrictive control is
exercised over the movements or attendance at work of adult
contacts, unless they happen to be teachers, school caretakers or
persons engaged in the handling and distribution of food. On the
other hand, all Education Authorities throughout the country
apply regulations for the exclusion from school of all contacts of
school age from infected households.
Exclusion of School Contacts.
The "Memorandum on Closure of and Exclusion from School"
is an official document issued under the joint auspices of the Ministry
of Health and the Board of Education; and the Regulations of
Local Education Authorities are based on the procedure recommended
in that Memorandum.
With regard to school children suffering from scarlet fever,
the procedure suggested in the Memorandum implies an official
belief in the necessity for a six weeks detention period in hospital,
and an even more surprising belief in the efficacy of terminal
disinfection. These, I submit, are the cast-off tenets of an outworn
creed.
It is with the exclusion of contacts, however, that I am more
concerned at present. The Rules suggest that, when a person
suffering from scarlet fever is being treated at home, all school
children living in the same house (which may contain two or more
families) should be excluded from school during the whole period
of illness and for a week thereafter. The reasons given in the
Memorandum for such exclusion of contacts are:—
(a) "Because such children, if unprotected by a previous
attack, might attend school while suffering from the
disease in a latent form or at an unrecognised stage."
But the suggested Rules for exclusion—appearing later in the
Memorandum—do not differentiate between children who have
and those who have not been protected by a previous attack.