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scarlet fever occurred in 339 houses, so that 84 or one-sixth of
the total were secondary cases. There were 283 houses in
which one case only occurred, and 56 houses or 16 per cent,
of the total, in which two or more cases occurred. In 1897,
18 per cent, of the total number of houses had two or more
cases.
21. Concealed and undetected cases attending Schools.—I
was informed by the head teacher of the school of two children
who were observed to be desquamating while in attendance.
I visited both cases at their homes; in the first I felt convinced
that the mother had acted with culpable negligence in
sending the child, but as usual there was no evidence to justify
a prosecution. The second case was, I believe, purely an
oversight on the parent's part.
22. Return Cases.—In four cases I learnt that, within a
short period previous to the patients being taken ill, another
child in the same house had returned home from the Fever
Hospital after having Scarlet Fever.
In none of these cases did I discover any sign of infectiousness
about the returned case, and they may have been mere
coincidences.
Dr. Simpson, Professor of Tropical Medicine at Ring's
College Hospital, is now investigating the whole subject of
return cases on behalf of the Asylums Board.
Diphtheria.
23. There were 110 cases of Diphtheria notified, compared
with 131 in the preceding year. The number of cases was
fewer than for six years, as Table E shews.