[Report 1925] / Medical Officer of Health, Bognor U.D.C.
- Bognor Regis (England). Urban District Council.
- Date:
- 1925
Licence: Attribution 4.0 International (CC BY 4.0)
Credit: [Report 1925] / Medical Officer of Health, Bognor U.D.C. Source: Wellcome Collection.
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![the homes. About midway through the epidemic, a “ missed ” case was found in the Council Schools, and tliis case was probably responsible for re-starting the epidemic after a quiescent period of some three weeks ; thereafter the infection seemed to spread from case to case. As far as the South Bersted Schools were concerned, there M ere tuo separate and limited outbreaks. Missed cases M^ere found on each occasion, and whether these cases Mere responsible for the outbreaks or not, their detection and isolation terminated the course of the infection. The question arose as to Mhether the severe epidemic of Diphtheria in the schools during 1919 and 1920 played any part in the subsequent outbreak of Scarlet Fever by loMeiing the general resistance to infection. Examination of the records does not support this view. Of 174 children who had Diphtheria during 1919 or 1920, only 10 contracted Scarlet Fever in 1921. This result is only what would be expected ; as far as my experience goes, it appears certain that the resistance to Scarlet Fever is a specific one, not likely to be affected by any general debility^ During 1922 and 1923, which had 24 and 19 cases respectively, no definite paths of infection could be traced. The cases occurred sporadically all over the district and did not appear to be in any way related to each other. In 1924 (20 cases) there Mas a limited outbreak in a residential school occurring shortly after the beginning of the C'hristmas term. This outbreak accounted for six cases. A similar outbreak occurred in another residential school during 1925, caus- ing four out of the year’s total of 22 cases. A few cases during the early part of this year appeared to centre around a dancing class held weekly in the town; this is a source of distribution which should not be ignored. 1 have been impressed M'ith the fact that investigation not infrequently reveals that contacts of a definite case of Scarlet Fever have recently suffered from sore throats, M'ithout anj^ other sign of Scarlet Fever being present. It has been possible to observe some of these cases throughout the illness, and at no time have they had the slightest sign of a rash, nor have the}^ subsequently shoM^ed signs of peeling. Though it is noM’ well established that Scarlet Fever is due to a particular type of streptococcus it is also certain that there are other streptococci M’hich do not produce the disease, but are so like the responsible bacterium that they cannot be distinguished from it by ordinary bacteriological tests. It is reasonable to suppose then that the patient with a sore throat may harbour the Scarlet Fever streptococcus to which he is not susceptible, as well as the streptococcus causing simple sore throat, to M^iich he is ; and he is therefore able to transmit the Scarlatinal germ to a person mFo is susceptible to it. In other M ords there is probably the “ carrier ” of scarlet fever, just as there is a “ carrier ” of Diphtheria and other diseases. A test has recently been devised to discover M'hether an individual is sus- ceptible to the disease, and antitoxic serum is becoming available to confer im- munity on persons found to be susceptible. No Mork of this nature has up to the present been carried out in this district. iSiunmarising the question then, the sources of infection in Scarlet Fever nre :— 1. Direct contact M’ith another recognised case. 2. The ‘ ‘ carrier. ’ ’ 3. I’he “ missed ” case. 4. Possiblv infected articles, to a limited extent. 5. Milk. [Milk has been proved to be capable of carrying the infection, but this factor has not been present in any of the cases in the district during the last five years]. Diphtheria. Only 45 cases of Diphtheria have been notified in the district during the five years 1921-25, and of these, 21 ctT^ses were reported in 1921. The majority of the cases Mere very mild ; some indeed shoved no clinical signs of Di})htheria, but Mere more in the nature of Diphtheria carriers.](https://iiif.wellcomecollection.org/image/b28937053_0031.jp2/full/800%2C/0/default.jpg)
