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the year, only six cases were notified attending Gordon School, and
these appeared to be independent of school attendance.
45. Children, no doubt, often attend school in an infectious
state without spreading the infection as the following instance
shows. An anonymous letter informed me that two boys were at
home with Scarlet Fever, which was being concealed. On visiting
the house I found that the boys had returned to school
where I found them in class freely desquamating. They had
been absent for a few days, and admitted they had had a rash
and sore throat. This was probably a case of intentional concealment,
but it is impossible to show in such cases that the
parents were aware that their children were suffering from an
infectious disease. There had been no medical attendance.
The boys were aged 10 and 13 respectively, and in classes
where probably most susceptible children had already had the
disease. This may account for the fact that no other cases
occurred at this school.
46. After 17 years' energetic administration of the notification
and isolation enactments of the Public Health (London) Act, there
is some reason for surprise and disappointment at the occurrence
of so much scarlet fever last year. On the whole, however, there
has been in the last 20 years a decided fall in the number of cases
of scarlet fever and a great fall in the death-rate from this cause.
The disease is now spread by mild cases, many of which are never
suspected; others are concealed to avoid interference with the
course of family life, as by removal to hospital, and exclusion
from school.
47. The Annual Report for 1905 contained a special report on
a statistical investigation into school incidence of scarlet fever and
diphtheria during the ten years 1896-1905.
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