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11
In the latter class, 56 occurred in children attending Elementary
Schools, 21 in children who were either below school
age or had not been attending school, and 5 in children attending
a private school.
Careful enquiries were made in all cases, in order, if possible,
to trace the source of infection.
In some instances the source was fairly obvious, these being
those in which the disease had already appeared in some member
of the family, or in one of the playfellows or schoolmates,
with whom there had been recent contact. In others, the
patient had been up to London or to some place of entertainment,
and may have been there exposed to infection. When
cases occur, as they will do, sometimes at long intervals, in
areas remote from one another without its being possible to
connect them with any previous case, directly or indirectly,
one can onty class them as sporadic, but when Scarlet Fever
is unduly prevalent in any given area, the explanation of failure
to trace the infection among school children especially, lies
generally in the fact that some cases have been overlooked, and
that the children, while still attending school are infecting
others. Such cases are now and then discovered accidentally.
Sometimes they have to be sought for by the systematic examination
of all the children in a class or school, and the task
is not an easy one, for there may be little more than slight redness
of the throat or tongue, more or less indefinite, to guide
one.
Among the 56 children attending Elementary Schools:
infection traced, 18; infection untraced, 38. Exactly half of
b