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22 SCARLET FEVER.
Among the 272 reported cases were 12 in which the diagnosis was not confirmed by
the progress of the disease. Such "errors" formed 4 4 per of the total number of
cases reported, a proportion differing notably from that recorded in 1911 (14.1 per ),
and nearly 35 per below the average proportion (6.8 per ) for the five years 1907-11.
Among the 260 remaining ("definite") cases were 18 in which the infection was believed
to have been acquired outside the Borough, 6 in which it was contracted in hospitals
where the patients were under treatment for other complaints, and 14 cases which followed the
return home from "fever" hospitals of previous cases. Three patients were certified to have
diphtheria and scarlet fever at the same time, but in one case only was the mixed infection
confirmed at hospital, although in one of the other two cases the Klebs-Loffler bacillus had been
demonstrated bacteriologically before admission. One patient, who had a definite attack of the
disease in April, 1909, had a second definite attack in November of last year.
The 272 notifications were received from 224 houses, 32 returning two and 8 three. The
house distribution of the notifications during the past year compared favourably with that
observed in the preceding four years. (See beloiv.)
Scarlet Fever.
(Notifications.)
1912. 1911. 1910. 1909. 1908.
Houses with 2 each 32 16 23 62 57
3 „ 8 3 9 26 30
4 „ — 2 3 3 13
„ 5 „ . 1 1 1 5
,, 6 — . — - .1
„ 7 „ - 1 - - 2
In three instances both the cases reported from the same house proved to have been
erroneously diagnosed, and in two houses whence two notifications were received two families
were infected. The distribution of multiple cases, after correcting for errors, &c., was as given
below, where the corresponding corrected figures for the three preceding years are also set out.
Scarlet Fever.
( Cases.)
1912. 1911. 1910. 1909.
Houses with 2 each 29. 14 21 59
3 „ 8 2 7 22
4 - 1 2 3
5 „ 1 1 1
Families with 2 each 27. 14 22 51
3 „ 8 2 6 14
4 „ 1 1 4
5 „ - 1 1 -
An examination of the particulars relating to the families with two cases show that in 2
instances the second case was a "return case"; in 7 both cases were reported on the same
day; in 5 the second case occurred whilst the first was being treated at home, and in one
instance the second case was apparently due to a relative visiting the hospital where the first
was in isolation. In three families the intervals between the two cases were so long that
independent infections were more than suspected, the intervals being as here indicated:—
28. i.—24. xii.; 14. v.—6. xii.; and 29. viii.—1. iii. In 9 families the shortness of the intervals
pointed to direct personal infection:—18—21. iv.; 30. xi.—6. xii.; 3—4. xi.; 29. xi.—11. xii.;
1—9. vii.; 29.x.—1. xi.; 19—21. xi.; 25—27. ix.; 19—20. x.
The intervals elapsing between the first and second cases in the 5 families keeping their
patients at home were as follow: . 1 day an J 5 days in one instance each; 6 days in two; and
24 days in the fifth.