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74
In this way three children, in the peeling stage of Scarlatina, were
found and removed before any further cases arose.
From September the 7th to the 11th, five cases of this disease were
notified in children attending the Selwyn Avenue Schools, and in consequence
I visited and examined all the children of two suspected classrooms,
excluding a number who within a few days failed with the
disease.
The class-rooms were disinfected and I kept up daily visiting until
the end of the month. By this time twenty-four children were affected.
The Education Committee were early made aware of the circumstances,
but on my advice the School was not closed, as I felt sure the cause of
the outbreak was some child in attendance who had mild Scarlatina.
I was convinced of this in the second week of the outbreak by
discovering—among those in attendance—a child with evident signs of
commencing peeling on the hands, and the history of her illness during
the holidays bore out that suspicion.
In the following month, October, I was able to report to the Sanitary
Committee that " the slight epidemic among the Selwyn Avenue School
children had come to an end." Unfortunately two of the children who
first contracted the disease in September, returned to School in
November, after eight weeks' isolation, and a fresh crop of cases arose.
These two children—a boy and girl—when discharged from Hospital
were apparently in perfect health, but on their return home must have
acquired an infectivity which I can only attribute to their change in
surroundings causing nasal catarrh.
From the boy a sister, who was not at School, contracted the disease,
and there was little doubt of the part he played in the second outbreak.
The girl, owing to nasal discharge persisting, I suspected as the cause of
other cases arising outside the school, and had her removed a second
time to Hospital, following a bacteriological examination, which showed
diphtheritic bacilli in the throat and nose.
With the removal of these, infection ceased, but the school became
greatly depleted, owing to the alarm of the parents. Had the school
been closed on the appearance of the first cases, without discovering the
real cause of the outbreak, on re-opening the school, the child primarily
responsible would have come back and caused a second outbreak, and