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11
made by a Joint Committee of the County Council for the
treatment of Smallpox cases. In the meantime cases would
be sent to Darenth or Barnet. Arrangements have been made
with the Croydon Borough Hospital for treating cases of
Scarlet Fever and Diphtheria from houses when special circumstances
render removal advisable, and the arrangement
answers well. Enteric Fever is treated in the Kingston
Victoria Hospital, payment being made by the Corporation.
The isolation in hospital of ordinary cases of Scarlet Fever and
Diphtheria has not been found necessary. Cases rarely spread
in the households and cases of infection being carried to other
houses are unknown as far as I have been able to ascertain.
Disinfection is by burning sulphur in the rooms or by
spraying with formalin. Bedding, &c., is sent to Lacey's,
Wandsworth, but a disinfector at the Dust Destructor is under
consideration.
MEASLES.
Nine deaths from this disease ; two under one year of age
and the rest in very-young children. The epidemic was considerable
all over the Borough. There was no definite spread
from one school to another, but the schools were not all
attacked at the same time. On my recommendation the
Elementary Schools were closed for 16 days, so as to tide over
the incubation period, from April 14th. After this the
epidemic soon died out, but the continuance of isolated cases
and secondary cases amongst children who had been attacked
at the beginning of the outbreak, show that the force of infection
had worn itself out rather than that it had been
checked by school closure. The inquiry instituted in Woolwich
in 1902, at the instance of Dr. Kerr, by the School Board for
London, has been carried on since, under the London
Education Committee, by Dr. Thomas, and Dr. Davies the
medical officer of health. Owing to the circumstance that in
the eastern half of the borough an attempt was made to
suppress every appearance of measles in a school by rigorous
class closure, while in the western half the system of excluding
individual children was followed, the inquiry has something of
the value of a scientific experiment. The result of the
experiment in 1903 was interesting. The statistics showed
that class closure had been much more costly in interfering