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34
In connection with the usually observed decrease of scarlet fever during the August holiday
month the question has in previous reports been considered to what extent this decrease has been due
to decrease in the London population, owing to the customary exodus from London of persons who
take their holiday in the country at that time of the year. The Local Government Board supplies to
medical officers of health a weekly return of notified cases of infectious disease in London and a number
of other communities, and it is interesting to note that in 1905 there was a decrease of notified cases
of scarlet fever during the holiday month in places to which it is usual for many persons to resort at
that time. The return referred to does not include all the principal places of holiday resort in England
and Wales, but the total number of cases of scarlet fever notified in 44 of these localities1 selected as
especially likely to have influx of population during the holiday will be seen by the following figures
to have decreased during that month. (See also Appendix II., page 30). The number of notified
cases in London is also shown:—
Period.
London.
Holiday resorts.
Cases.
"All ages."
Increase (+) or
decrease (.) per
cent.
Cases.
''All ages."
Increase ( +) or
decrease(.) per
cent.
Four weeks preceding weeks of holiday
influence 1,465 — 317 —
Four weeks oj holiday influence 1,557 + 6.3 205 — 35.3
Four weeks following weeks of holiday
influence 2,129 + 36.7 267 + 30.2
The variations in the age.incidence of scarlet fever mortality and their relation to school attendance
during the period 1861.1905 are discussed in an appendix to this report (see Appendix I.).
Proportion of cases of scarlet fever removed to hospital.
It will be seen from diagram IX. that the proportion of cases of scarlet fever admitted to the
hospitals of the Metropolitan Asylums Board was greater in 1905 than in any preceding year.
Scarlet fever—Age and sex distribution.
The following table shows the notified cases, deaths, case.rates, death.rates and fatality of
scarlet fever at the several ages and for each sex in London during the year 1905. It will be seen that
the death.rate and fatality was higher among males at "all ages" than among females, though the
case.rate was higher among the latter. In the age groups adopted for the purposes of this table,
the greatest incidence of attack was made upon both males and females of four years of age. The
greatest incidence of death was upon both male3 and females of two years of age. The fatality,
it will be observed, was highest among males of one and among females under one year of age.

1 Tunbridge Wells, Broadstairs and St. Peter's, Dover, Folkestone, Hythe, Eastbourne, Seaford, Brighton,
Hove, Worthing, Bognor, Portsmouth, Gosport and Alverstone, East Cowes, Newport (Isle of Wight), Ryde, St.
Helen's (Isle of Wight), Ventnor, Bournemouth, Southampton, Southend, Clacton, Walton, Lowestoft, Weymouth,
Exeter, Dawlish, Teignmouth, Torquay, Dartmouth, Plymouth, Devonport, Ilfracombe, Penzance, Weston.super.
Mare, Bath, LeamingtoD, Seaforth, Southport, Blackpool, Scarborough, Whitby, Aberystwyth, Bangor.
2 In the preparaion of this table the rates and percentages are calculated on the number of cases notified in
London, and the number of deaths occurring in London and the institutions belonging to London.