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32
the prompt removal to the Metropolitan Asylums Board's hospitals
of cases notified, and the rapid following up of contacts by the
sanitary staff.

Of the 439 cases of scarlet fever notified 265 {i.e., 60 per cent.)
were of children of school age.
Of the 7 deaths registered from the disease during 1910, 4 were
of children under 5 years of age.
In 55 of the houses invaded multiple cases occurred. In a
majority of the cases notified the source of infection, there was
reason to believe, was due to personal contact, the mild unrecognised
case playing, as usual, an important part in spreading infection.
So-called "return cases" were not so numerous during 1910 as
in the preceding two or three years. It is always a difficult matter
to definitely associate the discharged patient in crowded localities
as being responsible for infecting healthy persons on their return
home from hospital. Each such suspected case is exhaustively
enquired into, and in a certain proportion of cases it is impossible
to avoid the conclusion that the discharged patient is the cause of
infection. Having regard to the more frequent channels of infection
referred to in preceding Annual Reports, this as a source of infection
cannot be considered a matter of great importance. Precautions
are taken in the Health Department to reduce the risk to a minimum
of such cases arising.