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26
It was ascertained that A and B obtained their milk from the
same farm, which is situated outside your district.
The further investigation of this matter therefore appeared to me
to be a question in which the County Medical Officer of Health was
concerned. I therefore communicated with Ur. Young, who carried
out a most painstaking and exhaustive enquiry into the whole
circumstances. To him I tender my best thanks for much valuable
advice and assistance.
It is unnecessary here to give the details of the enquiry which Dr.
Young pursued; the conclusion reached was, that the milk from the
farm in question was in no way responsible. Further light was thrown
on the matter in the investigation of subsequent cases in a most
roundabout way.
A child living on the Hamborough Estate (North side), was
notified with Scarlet Fever on June 10th. On making the usual
enquiries the only probable source of contact was at a small private
school she attended in a neighbouring street; this clue was followed
up by visiting the school, one of the children there was found to be
desquamating from Scarlet Fever. She had been back to school four
days after an absence of three weeks I learned that her brother was
ill a short time before she was, and that he was a scholar at
Featherstone Road Boys' School (South side). A messenger was at
once sent to the Medical Officer to the School Board to examine this
boy in school. He was found to be desquamating. At their home,
I found another child, three years old, peeling from Scarlet Fever;
from the history the disease had been in this house for at least a
month. The milk supply to this family was derived from A, which
he delivered in small cans. Here then was a most probable
explanation of the infection of A's milk supply through infected cans,
early in May. These cases were directly responsible for several
others in the same street, which were discovered by the notification to
us of a case of Scarlet Fever, the patient being a domestic servant in
Ealing, whose home adjoined the house in which these cases occured.
In this house I found two cases of Scarlet Fever, and from this house
in turn three other cases arose in an adjoining house through direct
contact.
About this time also another unrecognised 'centre' was found in
Kingston Road; through enquiries made respecting a case notified
from a house in the same street. This unrecognised case had been
in attendance at school for a fortnight, subsequent to the first days of
her illness.
During July, quite a number of children were found in the
Elementary Schools peeling, six in Dudley Road Girls' School, and
one in Featherstone Road Boys' School.