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20
SMALL-POX.
There was no small-pox in the Borough during the year.
SCARLET FEVER.
During the 52 weeks ended Saturday, December 29th, 1906, the number
of scarlet fever notifications, excluding duplicates, was 1.37; 74 belonging to St.
Giles and Bloomsbury, and 63 to the Holborn District. In the St. Giles District
65 cases were removed to hospital, and in the Holborn District 59.
In 1905 the number was 156, in 1904—99, and 1903—144.
Secondary Cases of Scarlet Fever.
Of the 137 cases of scarlet fever, 98 occurred at houses in which there was
no second case. In twelve houses there were two cases, in one of which the
primary case occurred the preceding year. In four houses there were three
cases, and in one Institution there were four cases notified.
In the majority of instances the secondary cases occurred, because the
primary case was isolated at home, or was not promptly notified and removed to
hospital.
Return Cases or Scarlet Fever.
Of the secondary cases of scarlet fever six were "Return" cases, i.e., cases
which occurred in a house soon after the return home of a patient from hospital.
In two of the cases the patients had been at the hospital for more than 12 weeks.
In the year 1905 there was only one return case, and in the year 1904 there was
no return case.
Of the five patients giving rise to the six "return" cases, one had a small
sore on the scalp, and a sore nose with a watery discharge the day following his
return from hospital, and another had a sore nose about a week after his return
from hospital. The other three patients had been apparently well since their
return.
In each of the houses disinfection was satisfactorily carried out, and in no
case could any other source of infection be ascertained.
Errors in Diagnosis.
During the year seven patients were returned from the Metropolitan
Asylums Board hospitals as not suffering from scarlet fever; four of them on the
same or the day following their admission, and the remaining three after an
interval of a fortnight to a month.
In previous Annual Reports I pointed out the great need there is for
increased isolation accommodation in contradistinction to segregation in large