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61
the spread of infection. Many cases, which might have been prevented
had timely medical aid been sought, have been traceable to
this cause. There have been a larger number of cases during
1908 than in the preceding two years, in connection with which
there has been more or less evidence pointing to a recently discharged
patient from one of the M.A.B. hospitals as the source
of infection. These so-called "return cases" are, of course,
very difficult to trace; but here again the inference has in a
large number of these cases been unusually strong, that the returned
patient has been the infecting agent. In all such cases
special enquiries have been instituted, and the history of a typical
suspicious case will be found set out below.
The most satisfactory—one might term it the only satisfactory
—feature of the report dealing with the incidence of this disease
has been the low death rate. While it is clear that the mildness
of the type is to some extent responsible for this satisfactory state
of things, it is equally clear that the prompt isolation by removal
to hospital of such a high percentage (96.9 per cent.) of the cases
notified is a contributing factor to this desirable end. Difficulties
have at times been encountered in securing removal of patients to
hospital through the mistaken opposition of parents and others in
some few cases in which such removal, in the interest of the
public health, was indicated, but these were in all cases satisfactorily
overcome