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cases undetected or concealed, which go about and attend school,
is no doubt very large and mainly accounts for the spread of
infection.
Special outbreaks occurred at Goldie Leigh Poor Law Schools,
Eltham National and Gordon Schools. 30 cases occurred at
Goldie Leigh. These children attended Wickham Lane County
Council School, and were said to have no other place of general
meeting. No other children attending this school had recently
been notified with Scarlet Fever, and there was hence no reason to
suspect that the infection originally came from the school. As,
however, it obviously spread through the attendance of the Goldie
Leigh children at the Wickham Lane School, the children were
excluded from school for three weeks, after which the outbreak
ceased.
For the second year in succession, Gordon School was the seat
of a considerable outbreak. After the occurrence of five cases at
this school, Dr. Thomas, of the London County Council Education
Department, examined the children in affected classes at my
request. The probable source of the outbreak was found in two
children—a boy who had been absent from school for two weeks
with vomiting, headache and sore throat, and was found to have
nasal discharge by Dr. Thomas, after being back several days at
school— and his sister, who, though she was not known to have
been ill, was found to be desquamating on her hands. The boy
had had medical attendance, but the doctor had not diagnosed
Scarlet Fever. The first notified cases sat in school near these
children. They, and other suspicious cases, were excluded until
certified free from infection. A large number of suspicious cases
absent from school were visited by your Medical Officer of Health,
and one at least was found to be suffering from a mild form of
Scarlet Fever. Notwithstanding these steps, the disease continued
to spread till, on my request, the school was closed for
three weeks on October 21st. From October 31st to the end of