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126
SCARLET FEVER.
In the schools during- 1911 there were 191 cases of this
disease, as compared with 109 in 1910. Now that more
medical assistance has been provided it will be possible to
take further precautions for the prevention of the spread of
this disease. During the year, at the end, there was a small
outbreak at one of the schools. As it seemed impossible to
locate it to a class-room, every child in the school was
examined for the presence of any sign or symptom of an
unrecognised attack of Scarlet Fever. As a result, about
20 children were excluded from attendance for a week. They
were again seen at the end of a week, when two-thirds of
them were allowed to attend. The other third were excluded
for another week, and so on until they all appeared to be
safe to return. By this means the whole outbreak came to
an end, and the school was cleared. By following up all
notified cases to the school and examining contacts I am of
opinion a great deal of good can be done. The difficulty is,
of course, the time required to carry it out systematically.
Every effort is made to trace the origin of each case, but
in the majority of instances this is a very difficult matter.
The communication with other districts is so free that there
is always the possibility of infection through an unrecognised
slight case moving about. The far greater number of patients
are of school age, and, seeing how persistent the disease has
been, it seems to me worth while for the Council to consider
—as an experiment in the first instance, I should suggest—
as to whether it would not pay them, from a public health
and also from an education attendance point of view, to
appoint a health visitor to follow up all cases of suspicious
illness which might be notified to me from the schools. This
would cost them less than £100 a year, and if any material
reduction could be made in the incidence of Scarlet Fever of
course it would be money well spent. Quite recently an
addition was made to the accommodation at the Isolation