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12
potent source of infection than the dead particles of shed
skin. A discharge from the ear is known to be infectious,
and latterly carious teeth have been suspected of harbouring
the germs of the disease.
Notwithstanding all the precautions which Dr. Shannon
takes at our Isolation Hospital, we had two "return"
cases in one family.
It is interesting to note that our systematic enquiries in
each case very rarely show the disease to have been carried
indirectly by clothing or toy a second person.
It should toe borne in mind that the Scarlet Fever poison
may have in some people no other effect than to produce
a slight sore throat, and this being unrecognised, but nevertheless
infectious, may lead one to suppose that infection has
been carried indirectly in the clothing or by the hands,
whereas in fact it may be a case of direct infection. Two
of our cases were clearly proved to have been contracted
in this manner. In no instance was there reason to suspect
that a medical man had carried the disease from one patient
to another, although 16 cases were treated in their own
homes.
DIPHTHERIA.
Average number of cases each year during the last 10
years, 1895-1904 = 24.5 cases.
74 cases were notified. 60 were removed to the Infectious
Hospital and the others were treated at home.
All except six of the cases occurred in the homes of the
working class.