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manifested in some only by a throat involvement, but in others with, in
addition, a rash, a rash which was so often evanescent. The children
with the rash were notified as cases of scarlet fever. The first of the
schools to be affected in this way was the infants' department of Priestmead.
One case was notified in the week ending May 13th : in the
following week it was later found that nine children succumbed. Not
all of these were known of at the time, as some were not notified until
later. This delay in notification was sometimes the result of the medical
practitioner having to wait some days, possibly until desquamation
started, to confirm his earlier suspicion that the child was suffering from
scarlet fever. In other cases the rash could be so fleeting as not to be
seen at all by the medical attendant, who could then feel satisfied that the
case was one of scarlet fever only when desquamation started. The delay
in notification in some cases would be for these reasons. In others,
however, it seems that the delay was the result of a failure on the part
of a medical attendant to comply with his statutory obligation to notify
a case on his first becoming aware that the patient was suffering from a
notifiable condition. At this school in the following week, two further
cases were notified, and in the next week another 8. In the succeeding
weeks the numbers of children notified as suffering from scarlet fever
were 0, 3, 0, 3 and 0 ; the school being free by the week ending July 9th.
Apart from these cases of scarlet fever were the very large number of
children who suffered from a sore throat but with no rash, while in addition
many members of the teaching staff were similarly affected. No children
who were suspected of being carriers were detected, nor did examination
of the feeding arrangements, or of the kitchen staff lead to the conclusion
that the outbreak was food-borne.
In June many of the pupils at Grimsdyke School suffered from
sore throats, but only four, spread over four weeks, were notified as
suffering from scarlet fever. In the latter half of June and the first half
of July, many of the pupils at Cannon Lane School were notified as
suffering from scarlet fever. Over a period of five weeks, 8 children
attending the infants' department were notified ; a large number of these
were members of the same class. Over the same period 5 of the pupils
attending the junior department were also notified. Then in the last
three weeks of the summer term, 6 cases were notified amongst the
children attending the infants' department of Roxbourne School. In
the winter term the most prominent groupings occurred in the infants'
department of the Pinner Park School. Here 10 cases occurred in the
space of three weeks, the pupils being members of five different classes.
These are the instances in which the number of cases and the
groupings are sufficiently closely associated as to suggest that school
attendance was the causative factor in the infection of many. On the
other hand no definite carriers were found and the outbreaks died out
without it being possible to take any specific steps such as the exclusion
of carriers which might have contributed to the abatement.
There were during the year smaller groupings suggestive of school
infections. While they might have been the result of infection at school
these groupings might also have been merely coincidental.