Dr. Page's report to the Local Government Board on recent prevalences of scarlatina at Donington and Moulton, in the Spalding rural sanitary district, in relation to school attendance / [David Page].

  • Page, David, M.D.
Date:
[1883]
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Licence: Public Domain Mark

Credit: Dr. Page's report to the Local Government Board on recent prevalences of scarlatina at Donington and Moulton, in the Spalding rural sanitary district, in relation to school attendance / [David Page]. Source: Wellcome Collection.

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    attacked, both in the immediate vicinity of previously infected households; in one of which the mother had first begun with sore-throat, and in the other a child of two years was the only member ill. 13. I made inquiry also as to other possible modes of scarlatinal spread besides that of personal communication, which might at one or another time have become concerned in the cause of the outbreak, but I could find none. Particular inquiry was made about the milk supply, but this had nothing to do with it. Regarding modes of personal communication, school assemblage appears to have been the effective means in disseminating infection. During the period covered by school attendance, leaving entirely out of consideration the three weeks in which the Sunday schools alone continued to meet, in 30 invaded families the first attacks were, with but one exception (the hawker, Wilson’s child, mentioned in paragraph 12), of children attending school. Eighteen of the families lived in Donington itself, and the remainder elsewhere in the parish. The average attendance at this time was 118 at the Infant School and 50 at the Elementary Girls’; and at the remaining schools, Elementary Boys’, Upper Girls’, and Grammar School, 63, 24, and 25 respectively. During seven weeks, when day and Sunday schools were closed, four families were invaded, and the only instance of extension to the parish was of a person who had visited an infected household in the town. In the later period of school closure, to which the December cases belong, there were obviously many possibilities of infection. 14. The chief incidence of the outbreak was, as might be expected, upon the elementary schools. The Infant School was worst hit (21 cases), then the Elementary Girls’ School (six cases), and the Elementary Boys’ (three cases); the Upper Girls’ and the Grammar School having almost complete exemption, and similarly of the mortality, this in 15 of the 16 recorded deaths has fallen upon ages from two to seven years. 15. There is some evidence of the probable mode of introduction into the schools of scarlatinal infection. Mr. Stiles had alluded to cases of scarlatina not identified, but set down to roseola by the medical attendant, and commonly spoken of as “red rash.” I now learnt from Dr. Jollye that occurrences of this kind had indeed taken place in his practice some time before the recognised outbreak on July 6th, in two families living about-a mile from Donington, on the Spalding road. By further inquiry I was able to ascertain that these were cases, although mild, of regular scarlatina. The two households are about 200 yards apart. In one a girl, named Headland, aged 10, had been attacked on April 17th, and would seem to have had abundant desquamation. She returned to the Elementary Girls’ School on May 15th. In the other case (Green’s, where three deaths have been mentioned to have taken place in the later outbreak) a little girl of seven, attending the Infant School, began on June 12th and returned to school on July 4th. During her illness three other children went regularly to this school. In both instances the parents stated that they had no suspicion at the time of the real nature of the illness, and had therefore not adopted any sort of precautions as to disinfection. 16. The origin of the recent prevalence in Donington thus shown to have been continuous with earlier occurrences of unrecognised scarlatina may, with all probability, be referred to an extension from adjoining districts, for I gather from Mr. Stiles’ reports that since 1880 scarlatina has, at intervals, kept cropping up in one after another of the villages lying on the main road from Spalding; Quadring, a village two miles south of Donington, being the latest in this series. Between these villages there is frequent inter-communication. 17. At the second closing of the schools these were subjected to thorough disinfection and cleansing by means of sulphur fumigation, scouring of all woodwork and school furniture with carbolic acid solution, and limewashing. The appearance presented by the class-rooms on the occasion of my visit certified to the thoroughness of the work.