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As will be seen from the portion of the Report dealing with
the work of the Isolation Hospital, the original diagnosis had to be
amended on several occasions.
Smallpox.—No cases of smallpox occurred in the district
during 1938.
Vaccination.—No primary vaccinations or re-vaccinations
under the Public Health (Smallpox Prevention) Regulations, 1917,
were required during 1938.
Scarlet Fever.—Ninety-five cases of scarlet fever were notified
during the year, as against 61 in 1937.

Sixty-six cases were removed to the Isolation Hospital, representing
69.4 per cent. of the total number of cases notified.
Twelve "secondary" cases occurred in houses from which
previous cases had been notified. In each instance the primary
case had been removed to hospital. One ''return'' case was notified.
Two of the cases occurring during the year were "imported."
The confusion regarding the notification of this disease, still
anachronistically known as "scarlet fever," persists. There now
does not appear to be the slightest doubt that many cases occur
which have all the symptoms except a rash. These cases are highly
infectious, and are a potent means of spreading the disease
from person to person. Equally, many other cases present none
of the symptoms of scarlet fever except the appearance of a more
or less typical scarlatiniform eruption. These cases, which in many
instances are never infectious, are usually notified, and find their
way into an Isolation Hospital. While there, they may easily
pick up a variety of streptococci, which are then harboured in their
throats and noses for an indeterminate period. Thus, the end
result is that such non-infectious cases are converted into
potential "carriers." One can easily see how ludicrous the position
becomes. Very fortunately, the type of scarlet fever met with in
Southgate during the past few years has been exceptionally mild.
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