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11
SCARLET FEVER.
Fourteen cases of this disease were notified, as compared
with 35 in the previous year. Eight of these were
removed to the Isolation Hospital of the Hendon Rural
District Council under the arrangement in force between
that Authority and yourselves for the treatment of scarlet
fever and diptheria cases. Again, in all cases where
early notification was made and prompt removal or isolation
effected, the spread of infection was stayed. In one
instance a return case set up the disease in 3 other members
of the family. This case had not been treated in
the Isolation Hospital, but at the Mary Wardell Home
at Stanmore. As in previous years, extreme difficulty in
tracing the source of infection was experienced in the
majority of the cases and we were forced to the conclusion
that "ambulant" and "missed" cases, in which
the symptoms of illness are so slight that the real cause
is not suspected and remains undiagnosed, although these
cases are infectious to others, were the cause of many
outbreaks. None were traced to polluted milk or water
or other sources capable of diffusing the infection through
a wide area. At one time, early in the year, it was
noted that many cases of infectious sickness were occurring
amongst children attending a certain private school
which was held in a temporary iron building, used also
as a Sunday School. On inspection, this was found to
be in a very bad condition. The space under the floors
was badly ventilated, the soil being worm-eaten, decomposed,
and covered with a fungoid growth ; the timbers
were also much affected with dry-rot, and there was
nothing under the floors but earth. The sanitary arrangements
were also defective. The old soil was carted
away, the whole underneath space and woodwork well
done over with creosote, and many new ventilating
gratings inserted. The day school was transferred to
other quarters.
DIPHTHERIA.
The number of cases of this disease notified was 13.
All were promptly removed to the Isolation Hospital,
where, I regret to say, 2 terminated fatally. Parents and
others in charge of children need reminding of the imperative
need of calling in medical aid as early as
possible in this disease. Even a few hours' delay may
make all the difference between safety and the utmost
danger to life. There were one or two examples of this
amongst the series of cases notified in this district during
the year. Patients recently discharged from hospital after