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children fell ill, all about the same time, 12 days after the onset of the
illness in the primary case who was nursed at home. In three instances
the primary patient was removed to hospital; in one the onset of the
secondary case was the day before the removal of the primary; in another
it was the day after, but in the third there was an interval of 10 days.
The intervals between the dates of onset of illness in the primary and in
the secondary cases where the primary case was nursed at home, was
two days in one case, three days in two, six days in two, and twelve days in
two instances. In all but one of these cases, then, it can be presumed
that infection of the secondary case would not have occurred had the
primary case been removed to hospital.
There were no return cases this year, that is, cases of infection
occurring within a few weeks in a house to which a person who had been
nursed in an isolation hospital had returned.
In three instances, scarlet fever developed very shortly after children
had had their tonsils and adenoids removed.
It is possible that at Stanburn School attendance at school might
have had some effect in the development of scarlet fever amongst some
pupils, though no source of infection was detected and the occurrence of
cases ceased without any specific action being taken. In the second
half of February and in March, a case occurred in either the Junior or the
Infants' Section of the school for each of six consecutive weeks, two cases
occurring in one week. After a period of complete freedom, eight cases
occurred in two consecutive weeks in May; after a further interval, six
cases occurred in the Junior Department in a period of four consecutive
weeks. The only other suggestive groupings were four cases in one week
in Vaughan Road School; four in one week in Greenhill School; and
three in two weeks in Kenmore Infants' School.
SMALLPOX
Throughout most of each year, the only concern of the Health
Department with smallpox is to keep in touch with those who have come
to the district from some place abroad where they might have been
infected. Occasionally, there is a more urgent contact as when persons
come to the district having arrived in this country by a boat on which
there has been a person suffering from smallpox. In the early weeks of
the year there were some repercussions from the occurrence of the cases
in Brighton, leading to a number of requests for consultation by general
practitioners in respect of persons suffering from suspicious rashes.
When a ship on which there is a patient suffering from smallpox
lands at any port in this country, particulars of all passengers and crew
are taken and the health authorities of the district to which they are
proceeding are advised. These contacts are visited in their homes,
informed that they are smallpox contacts and are advised to inform their
doctors and particularly to let their doctors know that they are smallpox
contacts, if for any reason they have to call them in. When possible, too,
the patient's doctors are informed that these particular patients are
smallpox contacts. These contacts are visited for something longer than
the incubation period of the disease. Amongst the passengers of a boat
which arrived at the Port of London in the middle of February was a girl