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51
A district in which as many as 200 cases of Scarlet Fever
are nursed at home in one year suffers much indirectly. It has
already been pointed out that there is a loss of 1,000 school
weeks through exclusion. Cases of difficulty arise where a
contact is excluded from his work for the period the patient is
maintained at home, some firms apparently working on an
llogical cast iron rule that all such contacts must be excluded.
represpective as to whether the contact has previously suffered,
or whether he is prepared to abstain from contact with the
pratient. In the vast majority of cases the exercise of this rule
is unnecessary. Whilst in some occupations such as dairying,
any such regulations must be stringently enforced, it seems
umnecessary to exclude such persons as clerks in general offices,
more particularly when it is realized that early symptoms in
adults are more marked and more readily detected than in
children. Teacher home contacts are excluded for a period,
yet many a child is in school whilst sickening for, and in some
cases, actually suffering from the disease.
In popular opinion Scarlet Fever is still a dread disease, and
accordingly rules are enforced in respect of it which give
to much hardship, inconvenience and financial loss.
Secondary Cases.
Of the primary cases 178 were treated at home and 98
removed to hospital mmediately. Of these home treated
primary rases 28 gave rise to 34 secondaries, 24 giving rise to 1.
2to2 and 2 to 3 cases. This large number of secondary cases
must not be attributed entirely to the absence of isolation
accommodation, as many would have occurred even were there
such facilities. In fact the laximum number which removal
of the primary would possibly have prevented is 11, giving
rise to 14 cases. Of the others that would have been infected
in any case, the Doctor was not called in to the primary until
after the notification of the secondary, in many cases not until
the onset of the secondary and both diagnosed together- in
9 instances, whilst in another 8 the primary was a missed
case with no Doctor called in. No case occurred subsequent
to the freeing of a house from infection. The following figures
shoe the population per house in the three classes of cases.
Under 15. Over 15.
1 Home treated primary cases
2 where secondary occurred 3.03 2.14
- Home treated primaries with
no secondaries 2.33 2.29
Hospital treated cases 3.22 2.40