View report page

57
case, the wound was swabbed and haemolytic streptococci found,
so the child was readmitted.
The time intervals between the return home of the infecting
patient and the onset of illness in the return case were the same in
the series where the infecting patient showed no abnormality as
in the series showing some abnormality. Of the 28 cases in the
former series, 13 succumbed in the first week, 11 in the second,
three in the third and one in the fourth; and of the 13 in the other
series, six in the first week, five in the second and two in the third.
The sexes of the infecting patients were almost exactly equally
represented. Of the return cases females preponderated in the
proportion of three to two. Of the 25 females three were the
mothers of the returning patients. This heavier incidence amongst
females suggests that isolation of the patients on their return home
is not practised.
The ordinary uncomplicated case of scarlet fever is discharged
from hospital about the twenty-eighth day from the onset of his
illness. Although many patients receive serum on admission, the
period of stay is not reduced on this account. Adult patients, if
uncomplicated, are frequently discharged in the fourth week. The
following analysis shows the time of detention of those patients
whose return home was followed by the occurrence of a return
case:— Number discharged under 28 days, three; number discharged
on the 28th day, six; in the fourth week, 11; in the sixth
week, seven; in the seventh week, 4. Ten patients had been
detained over eight weeks, the time ranging from 59 to 107 days.
While the straightforward case is detained until about the 28th
day from the onset of his illness, if he is not admitted until late
in the disease, he is detained, even though uncomplicated, for a
longer period. The detention of any over this period is due to their
suffering from some complication. In many cases this is a nasal
or aural discharge which is probably infectious, and which it is
desired to clear up before the discharge home of the patient. In
these cases the detention of the patient is in the interests of the
public rather than that of the patient. In other cases, however,
the patient is detained for the treatment of some condition, e.g.,
nephritis, which is not infectious.