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41
There were 2 cases in one house in 25 instances, 3 cases in 10
instances, and 4 cases in 1 instance.
Cases occurred among soldiers in the various barracks in the City.
The Metropolitan Asylums Board has recently passed a resolution
to the following effect:—
"That in view of the continued prevalence of scarlet fever,
notwithstanding the extensive isolation accommodation which
has been provided, the Local Government Board be asked to
cause an inquiry to be instituted into the cause of this
disease, and whether any, and, if so, what further means can
be adopted for its prevention."
The anxiety of the Board has probably arisen from the great
increase in the number of persons who take advantage of their
hospitals; naturally expense has increased also, but not at a greater
rate than that of the number of patients treated. Dividing the list of
notifications given on a preceding page into three groups of five years—
(a) 1891-95, (b) 1896-1900, (c) 1901-1905—each, it appears that in the
first period 50 per cent, only of the notified cases of scarlet fever were
treated in the Metropolitan Asylums Board hospitals, in the second
period the figure had risen to 70 per cent., and in the third to 84 per
cent. There has also been an increase in the number of diphtheria
patients admitted. The number of scarlet fever cases notified per
10,000 of the population has decreased from 523 per 10,000 to 432 in
the second period, and to 35'5 in the third period. There has been, moreover,
a marked improvement in the number of deaths. In 1891-95 4'6
deaths occurred in every 100 cases notified; that has gradually fallen,
so that in the last period only 2.8 deaths occur. If all or even part of
this saving of life is to be attributed to the skilled treatment under
good hygienic conditions which the Board supplies it is not likely that
the hospitals will be less used. Whatever may be the circumstances
of rural districts, in London the treatment of eases of scarlet fever at
home would lead to a serious dislocation of business, the cessation of
the work of the parents, and the interruption of education for the
children in the house. The flat or block type of building, which has
largely taken the place of single dwellings, also renders difficult effective
isolation in the house.
Although there has been an increase in the number of cases notified
in 1907 in some parts of London, as a matter of fact there is not so
much scarlet fever now as there was, notwithstanding the increase in
population. In the three groups of years already quoted there were
112,781 cases in the first five years (1891-95), 97,278 in the next, and
82,064 in the last (1901-05).