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32. With a view to considering whether any of the cases
can be reasonably attributed to failure of disinfection I have
examined all the secondary cases, i.e., the 228 cases which
occurred in houses where one case had already occurred during
the year.
The majority of these cases occurred within three or four
days of the primary case and no doubt derived the infection
from the same source as the primary case, or else from that
case itself before it had been diagnosed and isolated; 14 were
so called return cases, i.e., cases occurring within a few days
of the return from Hospital of the primary case. I find there
were only eight secondary cases which could not be accounted
for in either of these ways, and which might conceivably be
due to failure of disinfection.
It is more likely, however, that their occurrence in the
same house as a previous case is purely in accordance with
the law of probability. It does not appear then that the
Scarlet Fever prevalence can be attributed to failure of disinfection.
33. Isolation is, in my opinion, of far more importance than
disinfection, and in this respect matters are eminently satisfactory.
74 per cent. of the cases were isolated in the Fever
Hospitals, and I believe all the remainder had the means for
satisfactory isolation at home.
34. The propinquity of the Brook Fever Hospital has been
itself suggested as a cause of the prevalence of Scarlet Fever.
But this explanation I consider absolutely untenable. The
Hospital is separated by at least a mile from nine-tenths of
the population; the first years of its occupation were years of
diminished prevalence of fever: the South-West Ward, the