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44. In ten cases, infection was attributed to friends and
neighbours, and in 33 cases to school attendance, in 2 to lodgers
and in 3 to travelling. But the number of cases in which it is
possible to point to a probable source of infection is small, and
will probably remain so until the germ of scarlet fever is discovered.
It is probable that in this disease, as in Diphtheria, besides many
mild and undetected cases, there are numbers of children and
some adults who, without any symptoms, carry the infection of
scarlet fever in their throats and noses. Under ordinary circumstances,
such ' carriers' would infect others, seldom, if at all; but
when they- get colds and coughs, the germs are more liable to be
conveyed from the throat and nose of the carrier to other persons,
and they become, perhaps, as infectious as an ordinary case of the
disease.
45. If this theory is correct, it follows that there can be no
prospect of abolishing Scarlet Fever at present; the diminution
of the fatality of the disease by hygienic open-air treatment and
the separate isolation of the severer cases in cubicles, is the end
to aim at. Table V. shows that in Woolwich there has been a
considerable reduction in death-rate.
4G. The Schools which were specially affected by scarlet fever
were Greenhill, Vicarage Road, Gordon, and Purrett Road.
In December a mild epidemic of scarlet fever prevailed on the
Well Hall Estate, Eltham, where Gordon School is situated. A
number of children complained of nothing but sore throats. At
my request, Dr. C. J. Thomas, of the London County Council,
visited the school, and several children were excluded and two
classes were closed for two weeks. Certain classes at Purrett
Road school were also examined on my suggestion and several
children with suspicious symptoms excluded.
47. The Annual Report for 1905 contained a special report on
a statistical investigation into the school incidence of scarlet
fever and diphtheria during the ten years 1S96-1905.