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Of the 471 Kensington cases, 425 were removed to Hospital.
The mildness of the disease is reflected in the low death rate; there were only six fatal casss
in Kensington during the year, representing a case mortality of 1.27 per cent. The deaths in the
three preceding years were 2, 5 and 8.
Twenty-seven of the 471 cases of scarlet fever notified were patients in the same family as a
person who had, within the previous 28 days, returned from hospital after having been treated for
this disease. In addition, two of those developing the disease were members of another family
living in the same house as a person who had been discharged from hospital after scarlet fever less
than 28 days previously. Cases of this kind are called "return cases," and a very careful investigation
was made in each of the 29, with a view to ascertaining the source of infection.
Information was obtained that one of the "primary" cases had nasal discharge and that
another had aural discharge on leaving the hospital; it is possible that infection was conveyed by
the discharge in these two cases, but there was no evidence obtained that the infection had been
contracted from patients returning from hospital in the other 27 cases.
Seventeen cases notified as suffering from scarlet fever were found, after admission to hospital,
not to be suffering Irom any infectious disease at all, with the result that they were returned home.
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 are excluded from school 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 likelv 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 his 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.—Four hundred and three cases were notified during the year, 385 of which
were removed to hospital. The cases notified in the three previous vears were 274, 322 and 346.

Cases of mistaken diagnosis are not excluded from the above Table.
Home visiting, disinfection and school exclusion are carried out on the lines indicated under
the paragraph dealing with scarlet fever.
The number of Kensington deaths was 34, representing a case of mortality of 8'44 per cent.
In the three preceding years the deaths were 16, 24 and 25.
Five patients developed diphtheria within 28 days of a member of their family having returned
from a fever hospital after having been treated for diphtheria.
On investigation it was found that two of the "primary" or returning cases had nasal
discharge on leaving the hospital, and it is possible that in these cases the nasal discharge was
responsible for the spread of infection. There is no evidence to show how infection was conveyed
in the other three cases.
Twenty-six notified cases admitted to hospital were found not to be suffering from diphtheria
or any other infectious disease.
Owing to the degree of accuracy which has now been secured by bacteriologists in the
diagnosis of diphtheria, it is customary to take a throat swab for bacteriological examination in all