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93
The distribution of the cases in age groups shewed, as expected,
that the main incidence of Scarlet Fever falls on the 5-15 age-group,
thus:—
Under school age 86 = 190 per cent.
School age 285 = 632 „
Over school age 80 = 178 „
It is interesting to note that closure of the public elementary
schools for public holidays immediately resulted in a decrease in the
number of cases of scarlet fever notified, which is rather at variance
with the generally accepted view that, in an urban area such as
Hampstead, school closure does not in any way assist in the suppression
of infectious disease.
Most of the cases (96 per cent.) were removed to Infectious
Disease Hospitals and the Health Visiting Staff made most careful
enquiries.
As a consequence of these enquiries it was found that no less
than 29 patients after their discharge from hospital in a non-infectious
state had subsequently become infectious and given rise to "return
cases." It will be noted that the "infecting case rate" is 64 per cent.,
which is a high figure.
Before a case was regarded as responsible for a " return case "
it had to fulfil all the four following criteria :—
(1) To have returned recently from fever hospital after suffering
from Scarlet Fever.
(2) To have discharging nose or other obvious inflammation of
the naso-pharynx.
(3) To have been in close association with the secondary case.
(4) Swabs from the naso-pharynx to reveal the presence of
hemolytic streptococci.
Further examination of these 29 cases showed that their average
stay in hospital was 47 days; no case had been in hospital for less
than 28 days, whilst 5 cases had been in hospital for more than 56
days, and 2 cases had indeed been detained in hospital for more than
100 days. Whilst certain of these cases occurred, of course, in the
overcrowded tenement houses of the Borough, "return cases" were