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In the seven cases classified as "return" cases, the source of
infection was presumed to be some other member of the family or
occupant of the same house who had returned from hospital after
an attack of scarlet fever, within a month previous to the second
occurring. The child discharged from the hospital is generally
spoken of as the " infecting " case and the infected child as the
" return " case. Formerly these "return" cases were a source of
great anxiety to the hospital authorities as they were thought to be
due to premature discharge after an attack of scarlet fever, but
owing to the precautions now taken before discharge, these
"return" cases are very few in London. As regards the above
seven cases, it is by no means certain that we are correct in attributing
the source of infection to the case discharged from hospital.
In some of them no doubt this is correct, but in others the occurrence
of the second case is a mere coincidence.
Measles.
The number of deaths for 1915 was 110, against 79 in 1914,
88 in 1913 and 101 in 1912.
In the first quarter there were 52 deaths, in the second 52,
in the third 5, and in the fourth 1.
There was a considerable increase in the number of deaths from
measles, but this disease is subject to considerable fluctuations,
and as practically every child gets it at some period of its life, it
depends largely on the number of susceptible children in a district
whether an outbreak is likely to be large or small. Endeavours
have been made by means of notification and the application of
the sections of the Public Health Act dealing with disinfection,
etc., after measles to control the disease, but so far they seem to
have little or no effect whatever.
At the beginning of the present year, 1916, the Local Government
Board again returned to the subject with a modified form of
notification, namely, the first case that occurs in the house and also
the notification of German Measles. Notification is to be utilised to
discover serious cases and see that they are properly nursed, the