INCIDENCE UPON MILK-DRINKERS 



353 



fever ; (3) both scarlet fever and sore throat patients were isolated 

 together, but those suffering from sore throats did not contract 

 the scarlet fever ; and {c) some of the patients suffering from sore 

 throat had at the same time certain symptoms simulating scarlet 

 fever, such as desquamation of the skin, kidney disease, and 

 rheumatic symptoms. With this view of the specificity of throat 

 illness under similar circumstances Dr Parsons agrees.^ In the 

 Upton and Macclesfield scarlet fever outbreak of 1 889, there were 

 40 cases of sore throat which were apparently related to scarlet 

 fever for the following reasons : — (a) The sore throat occurred in 

 older persons, in whom rashes are less prone to occur, and who 

 had had scarlet fever ; {h) in some cases there was skin desquama- 

 tion ; ic) when the children suffered from scarlet fever the adults 

 in the same house suffered from sore throat ; {d) two cases of 

 diphtheria at the same period showed symptoms simulating 

 scarlet fever ; and {e) pyrexia and delirium were present in the 

 more severe cases of sore throat In 1894 Dr Kenwood reported 

 on an outbreak of sore throat at Finchley, with symptoms showing 

 possible alliance to diphtheria. The disease attacked persons in 

 good social position, and particularly adults.- 



It is impossible to generalise upon a few outbreaks, but these 

 facts are of a nature impossible to discard, and point clearly to 

 some relationship. Nor are such common features exceptional 

 in ordinarj"^ scarlatinal outbreaks. 



It may be said in passing that the incidence of throat illness 

 in certain milk supplies, is, so far as has been investigated, similar 

 to milk-borne scarlet fever. The record of the Upper Clapton 

 outbreak, for example, is as follows : — 



Many other illustrations might be cited of similar incidence upon 

 drinkers of implicated milk (such, for example, as occurred at 

 Macclesfield, Hackney, and other places). 



^ Report of Medical Officer of Local Government Board, 1889. 

 2 Brit. Med, four., 1895, voL i., p. 1 167, and Medical Officer's Annual Report^ 

 1894. 



Z 



