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In the 13 cases classified as " return " cases the source of infection
was some other member of the family or occupant of the
same house who had returned from hospital after an attck of
scarlet fever within a fortnight previous to the second case occurring,
in this case the source of infection in the second case is presumed
to be the child recently returned from hospital. The following
statement on the subject is reprinted from my Annual Report for
1 907 :- " A good deal of attention has been given to these so-called
" return " cases on the part of the laity, and also by medical authorities,
the former generally being inclined to attribute it to premature
discharge from the infectious disease hospital. As stated, however,
in previous reports, facts do not support this view, because in the
first place the cases are very few compared with the number discharged,
and it is second cases classified as " return " cases the source of infection
was some other member of the family or occupant of the
same house who had returned from hospital after an attck of
scarlet fever within a fortnight previous to the second case occurring,
in this case the source of infection in the second case is presumed
to be the child recently returned from hospital. The following
statement on the subject is reprinted from my Annual Report for
1 907 :- " A good deal of attention has been given to these so-called
" return " cases on the part of the laity, and also by medical authorities,
and in the second case it is sometimes those children who
are detained months over the usual time and that cannot be considered
to have been prematurely discharged who produce the
disease.
" The micro-organism which produces scarlet fever has yet
to be discovered, and the probability is that when this is made it
will be found it behaves in a somewhat similar manner to diphtheria,
and will be found to exist in the noses and throats of the
patients who either have not got the disease at all, or who have
recovered from an attack some considerable time previously.
Those patients who have suffered from complications leading to
pathological discharges from nose, throat and ears are more liable
to spread the disease than simple, uncomplicated cases."
Measles.
The number of deaths for 1913 was 88, against 101 in 1912,
51 in 1911 and 143 in 1910.
The annexed table gives the number of notifications received
from schools, the number of " contacts " excluded. In the first
quarter there were 29 deaths, in the second 43, in the third 13,
and in the fourth 3.
This disease is subject to considerable fluctuations, and as
practically every child gets it it depends largely on the number of
susceptible children and the number of foci in a district which
start the infection.