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39
"Return Cases" of Scarlet Fever, etc.—Not
infrequently, infectious disease, scarlet fever, diphtheria, etc.,
breaks out in families soon after the return of a "recovered"
patient from hospital. The matter has received attention
at the hands of the Asylums Board, who, a few years ago,
were disposed to attribute the occurrence of such " return
cases " to any but the probable cause; viz., the continued
infectiousness of the apparently recovered patient. The
Managers thought it a reasonable explanation of the occurrence
of such cases in this parish, to cite but one instance,
that your Vestry employed a contractor to do the work of
disinfection, and that superheated steam was not employed in
the process. But, resolving to make a more precise investigation
of the whole subject, in 1898, they appointed a medical
expert to inquire into return cases which should be reported
to that gentleman by the medical officers of health. The
investigation has long since been completed; but, I believe,
no report of the results has yet been published. A somewhat
striking group of return cases occurred in this parish. A girl,
suffering from scarlet fever was in hospital for fourteen weeks,
returning home in apparent health at the end of July: it was
noticed, however, that she had a nasal discharge. This child
resumed customary intercourse with her young friends, four
of whom shortly afterwards contracted scarlet fever. There
was no doubt that they were infected by their companion,
who had kissed them, and with whom they had played
both in the streets and within buildings. It is highly probable
that the infectious material was contained in the matter
passing from the child's nose, but possibly the throat also
remained in an infectious condition. So far as I was able to
ascertain, desquamation of the skin had come to an end; and
certainly the patient was away long enough to secure this
object, the long detention in hospital having, I assume, been
due to the continued discharge from the nose.