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as " proper lodging or accommodation," due care could not
have been taken to prevent spread of the disease; unless, indeed,
it be the fact that no amount of care suffices to prevent it
from spreading when once it has found admittance into a family
of susceptible persons. In a few instances, when removal was
obviously necessary to security, difficulty was experienced in
obtaining the parents' consent, but in no case was recourse had
to the compulsory powers of removal, such as they are, which
the Sanitary Act of 1866 confers. The patients were generally
children of school age. No child was knowingly allowed to go
to school from an infected house. The existence of the disease
was revealed occasionally by the registration of a death, and its
spread was in several instances the result of keeping patients at
home under circumstances that rendered nugatory any attempt
at isolation.
The following cases are cited in illustration of modes of
spread of scarlet fever, and as evidence of the necessity for an
Act providing for the notification of Infectious Disease, a subject
to be dealt with later on.
Scarlet fever broke out in a family living in a Mews, three children being
successively attacked, the first on August 7th. The malady was pronounced to
be " rose-rash," and no precautions were enjoined. While the children were
actively " peeling," two of them visited their father, who was butler at a large
house in South Kensington, the occupants of which were from home. The
children, moreover, were allowed to play in the Mews with their schoolfellows,
the result being that four other families became infected. In one family two
children were attacked simultaneously on August 17th, the cases being concealed.
A case occurred in each of two other families on the 21st August, and
these likewise were concealed, and a case on the 2nd September in a fifth
family. Nothing was heard of any of these cases until Sunday, September 4th,
when the first-mentioned (three) cases were found to be actively " peeling,"
but the parents would not allow the children to be removed. Four of the remaining
cases, in three families, were removed, but in one case, in another
family, the parents refused to allow removal. Here, then, we had eight cases
in one Mews, seven of which presumably might have been prevented by removal
of the first case.
A police-constable, having a wife and a family of five children,
was placed in charge of a mansion at South Kensington. About
four weeks before the family were to return to town—a family comprising
several children—scarlet fever attacked four of the caretaker's children. The