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79
Staff in following up and tracing doubtful cases, with a view
to their prompt isolation.
The question of "return" cases is still unsettled, the
investigations which the Metropolitan Asylums Board's experts
have been conducting into the matter yielding conflicting results.
This is unfortunate, having regard to the importance of the
matter, and to the need for adopting adequate precautions to
prevent the spread of infection in this manner. As in the
majority of instances the patients discharged from hospital
return to houses where other children reside, and in which it is
frequently impossible to secure even the most primitive isolation,
it is absolutely essential that some definite conclusion
should be arrived at, so that the necessary steps may be taken,
e.g., extending the period of isolation of doubtful cases.

The number of cases sent back from hospital notified as
Scarlet Fever, and in which the diagnosis was found to be
erroneous, was 55, or 5.9 per cent., as compared with 3.5 per
cent. in 1906.
A case in which the Health Committee found it necessary
to take proceedings under the Public Health (London) Act,
1891, was that of a man, J. M., who, while suffering from
Scarlet Fever, exposed himself in a public place. The case was
notified on the 11th September, and Inspector Marrable, on
visiting the house to make the usual enquiries, was satisfied
that the case could not safely be isolated at home, and he
accordingly persuaded, as he thought, the patient to go to
hospital. When the ambulance arrived, however, the patient
had left the house, and all trace of his whereabouts were lost.
Two days later he presented himself at the Grove Hospital,
where he was detained. It was stated that during the two