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113
In 13 instances a doctor notified two cases of scarlet fever
in the same house simultaneously. When enquiries were
made into these cases it was found that the onset of the
disease of both cases had occurred within 24 hours in only
eight instances. In the other five the differences in onset
were 3, 4, 6, 7 and 13 days respectively. Four of these instances
occurred in Eltham. Having regard to the number of simultaneous
cases and the number of multiple cases which can be
accounted for as return cases, there is not sufficient data
available to measure the influence of domestic overcrowding
upon the incidence of scarlet fever in the Borough. It has
not been possible to show, for affected households, the attack
rate per 1,000 persons under 15 not known to have had a
previous attack of the disease in question, according as they
are housed, namely, less than one person per room, one to
two persons per room, more than two persons per room.
Dick Test. The Dick test—a reference to which is made
in the prefatory note of this report—has not been employed
in the area so far as I am aware.
Home Isolation. 25 cases, or 6 9 per cent. of cases, were
isolated at home and in no instance did a return case occur.
Each case kept at home is under the supervision of the district
inspector, who makes frequent inspections at intervals in
order to ensure that the proper precautions for preventing
the spread of disease are being taken.
The Royal Arsenal authorities require cases to be removed
to hospital, or a certificate from the Medical Officer of Health
of efficient home isolation, before their employees are allowed
to return to work. During the year five certificates were
issued.
H