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Henry E-, aged 8, belonging to another family residing in the same
house, was removed suffering from the same disease. Charles B-did
not return from hospital until June 17. There was no reason to suspect
that the precautions as to disinfection were ineffective.
On July 3rd, 1903, Florence T-, aged 10, was removed from No.
18, W- Street with scarlet fever returning home on August 5, 1903.
Two days before the return of this patient a brother, aged 3, was certified
and removed suffering from the same disease. The measures taken as to
disinfection appeared to have been satisfactory.
Other instances of a similar character could be given and they indicate the necessity
of exercising care before arriving at the conclusion that when a case of scarlet fever occurs
in a household after the return from isolation of a patient who has been ill with that
disease, the recurrence of the disease has resulted through infection from the returning
patient. However, there is no doubt that in the majority of instances given in
the summary appended the recurrence of the disease in a household following upon the
return of a patient from hospital has resulted therefrom. Doubtless the steps practicable
for preventing as far as possible the occurrence of return cases will be fully dealt
with in the report of the Medical Officer referred to in the Board's letter of June last.
Meanwhile there appears no reason to doubt the Board's statement that they are taking
every means rightly to discharge their responsible duties, both as regards the patients and
the public.
SMALLPOX.
Smallpox was somewhat more prevalent in London during 1904 than in the previous
year. Altogether some 500 cases were certified, mostly in Bethnal Green
where there was a considerable outbreak in the early part of the year, in Stepney and
in Poplar. The deaths from smallpox in the Metropolis numbered 25, the death-rate
being 0.01 per 1,000 population. The first case during the year in Shoreditch occurred
in February. Subsequently four cases occurred in April, one in May and seven in
July. Altogether fourteen cases were certified; 13 of these were smallpox, and two of
them ended fatally. Both the fatal cases were in unvaccinated infants.

The cases are grouped according to ages in Table III. (appendix).