London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Leyton 1936
[Report of the Medical Officer of Health for Leyton]
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Three years have now elapsed since the modified procedure was adopted, and Table B shows a statistical comparative analysis of the incidence of scarlet fever among school contacts during the two-year period before and the three-year period since the modification of the regulations.
| (1) | (2) | (3) | (4) | (5) | |
|---|---|---|---|---|---|
| Primary Cases. | Contacts of School Age. | Ratio of (2) to (1). | No. of Contacts Attacked. | Percentage of contacts Attacked. | |
| 1932-3 Hospital | 662 | 816 | 1.23 | 19 | 2.3 |
| Home | 369 | 214 | .58 | 12 | 5.6 |
| Total | 1,031 | 1,030 | .99 | 31 | 3.0 |
| 1934-6 Hospital | 916 | 985 | 1.07 | 32 | 3.2 |
| Home | 502 | 308 | 0.61 | 13 | 4.2 |
| Total | 1,418 | 1,293 | .91 | 45 | 3.4 |
The outstanding difference between the hospital-treated and
home-treated groups is the ratio of contacts to primary cases. For
instance, in the period 1932-33 the ratio was 1.23 for hospitaltreated
cases and 0.58 for home-treated cases; in 1934-36 it was
1.07 for hospital and 0.61 for home cases. This is to be expected
when one considers that many cases are admitted to hospital
simply because the number of home contacts makes isolation at
home difficult. However, by accepting as the basis of comparison
the percentage of contacts attacked, the two groups are comparable.
When comparison is made between the percentage contactattack
rates of hospital-treated and home-treated cases it will be
seen that in each of the two periods the percentage was greater
when the primary cases were treated at home; but although the
difference is statistically significant in the first period, it is not so
in the second.
The important point, however, is whether the shortening of
the school exclusion period was followed by any significant change
in the risk, and it will be seen that such was not the case; for
although the resulting contact-attack rate during the second period
was slightly greater in respect of hospital-treated cases, it was
slightly less in respect of home-treated cases.
With regard to the loss of school attendance in the two periods,
the new regulations in force during the second period apply only
to contacts of home-treated cases; but it will be observed that
whereas in the first period 214 contacts lost at least 12,840 school
attendances, in the second period 308 contacts lost only 3,080
attendances.