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126 [1913
13 in June, towards the end of which the epidemic may be said to have commenced,
then 19 in July, 32 in August, 52 in September, 78 in October, 135
in November, and, finally, .162 in December, when it had not finished its
course, as it has continued since then.
Fatality.—Numerous though the cases were, yet the disease caused only
19 deaths, or 10 more than in 1912, although there were 506 more cases, and
the fatality only 1.4 per centum of the persons attacked. In former years
the percentage of deaths was much higher; thus : —
From 1891 to 1900 it was — 3.3
„ 1901 to 1910 „ 2.4
„ 1911 to 1912 ,, 1.6
It is very apparent, then, that the disease is of a very much milder type than
it used to be in former years. But it has only become so gradually. This
subject has been discussed very fully in former reports of the Medical Officer
of Health, particularly in that for 1909, where he showed that very few cases
of the severe form of the disease known as scarlatina anginosa and scarlatina
maligna were now seen; and he would direct reference to that report and also
to his report for 1910 for further particulars.
Hospital Isolation —Of the 1,317 cases which were notified, as many
as 1,230, or 93.4 per cent., were removed to a hospital—usually one belonging
to the Metropolitan Asylums Board—for isolation and treatment. This is
a very high percentage, and means that practically all the cases occurring
in tenements and the majority of those living in separate houses have been
removed. Were it otherwise, there would have been a complete upset in the
educational arrangements, for the Education Authority will not permit—and
rightly so—any children to attend school from infected houses, which, in the
case of this disease, would mean that these scholars would be absent from
school, on an average, for at least six weeks, which would entail not only the
loss of education to the children, but a pecuniary loss to the ratepayers,
because the staff of teachers would not then be doing to the full the work
for which they were engaged. It is plain, therefore, that what the ratepayers
lose in one direction they gain, or nearly so. in another.