View report page

53
A month later a child in the family developed a
laryngitis, the nurse who attended this patient developed
true scarlet fever, and 14 days later a maid in the house
suffered a typical quinsy with a hemolytic streptococcal
swab. This association of scarlet fever and "quinsy"
is not unusual, but this instance will indicate the difficulty
in the tracing of infection and in the control of
the epidemic. A further factor which may play a part
in the spread of infection is that the present economic
stress discourages the calling in of doctors to doubtful
cases, and results in the spread of infection to unprotected
children.
In 25 families more than one case occurred, in 11
after the return of the patient from hospital. The
fact that no less than 41 of the patients were adults
indicates the severity of the infection, and this follows
the usual experience that when the infectivity of the
organism is increased adults become affected.
Twenty-seven of the cases of children attended Burnt
Ash School, this being the school most severely affected.
Thirty-seven of the cases were not of school age, while
18 cases attended a private school. One private school
was severely infected from a case residing outside the
Bromley area. The incidence of infection at Widmore
Schools was increased by two mild cases attending in
an infectious condition as missed cases, otherwise the
schools in Bromley were comparatively free of infection
and in no other case was the school the cause of the
spread in infection.
At the time of writing the epidemic has abated,
and it is not expected that another will occur for six
years, this, of course, being subject to certain factors
such as is brought about by a change in character of the
population or by the developing of large housing areas.
Diphtheria.
The incidence of diphtheria remained stationary at
1.3 per 1,000 population, being lower than was expected.
Whether immunisation is holding this disease in check
I am not prepared to say, as the Immunising Clinic ha3
not been functioning long enough to give definite results