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53
During the past three years, the Borough has been comparatively free from scarlet fever and at
no time in this period has the disease existed in what might be described as epidemic form. The
mildness of the disease is reflected by the fact that there were only two fatal cases during 1925.
The deaths in the three preceding years were 6, 2 and 1. The disease has been of such a simple
form in recent years that it is desirable to consider carefully whether priority of admission to
hospital should be given to certain serious cases of measles in preference to mild cases of scarlet
fever where the home conditions are satisfactory.
Six of the 265 cases of scarlet fever notified were patients in the same family as a person who
had, within the previous twenty-eight days, returned from a fever hospital after having been
treated for this disease. Cases of this kind are called "return" cases and very careful investigation
was made in each of the six with a view to ascertaining the source of infection. Information was
obtained that one of the "primary" cases developed a nasal discharge a day or two after leaving
hospital and it is probable that infection was conveyed by the discharge to the "secondary" case.
In the other five cases no evidence was obtained as to how the disease had been contracted.
Immediately on receipt of notification at the Town Hall that a person is suffering from scarlet
fever, the home is visited by the District Sanitary Inspector for the purpose of investigating the
source of infection; children in the house are excluded from school for 14 days; and a pamphlet is
left at the home advising that a doctor should be called in if any other member of the family becomes
unwell, suffers from a sore throat or develops a rash.
Disinfection of the home and any articles likely to be infected is carried out on the day
following the admission of the patient to hospital, or in the case of a patient nursed at home, on the
receipt of a medical certificate that he is free from infection.
A child of school age is not allowed to resume school attendance until a fortnight has elapsed
since discharge from hospital or, in the case of a child nursed at home, a fortnight after the
doctor's certificate of freedom from infection has been received.
Diphtheria.—Two hundred and ninety-eight cases were notified during the year, 285 of
which were removed to hospital.

Cases of mistaken diagnosis are not excluded fom the above Table.
Thirty-nine cases notified as suffering from diphtheria were found after admission to hospital
not to be suffering from any infectious disease at all, with the result that they were returned home.
The disease appeared in epidemic form towards the end of the year, but the majority of cases
notified were of a mild type.
The number of Kensington deaths was ten, representing a case mortality of 3.4%. In the
the three preceding years, the deaths were 34, 14 and 15.
Eleven patients developed diphtheria within twenty-eight days of a member of their family
returning from a fever hospital after having been treated for this disease. In one instance the
returning case was proved to be responsible for four "secondary" or "return" cases; and in
another, the "primary" case probably gave rise to three "return" cases and one of the "return"
cases on coming home from hospital was responsible for the infection of a still further case. In the
remaining three "return" cases, there was no direct evidence that the infection had been contracted
from those returning from hospital.