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109
Parish of Wondssworth.
were so indefinite that the diagnosis was not arrived at
until the stage of desquamation, nearly six weeks from
the probable date of infection. This fact also made it
more difficult to ascertain definitely the exact cause of
the outbreak.
One theory has suggested itself to me and that is
that these 102 cases were not Scarlet Fever at all, but
after seeing the majority of the cases and examining them
carefully with the Medical Officer of the Institution, 1
came to the conclusion that it could be nothing but Scarlet
Fever with mild initial symptoms. Again, a few of the
cases had sore-throats, of a very mild and evanescent type
about the 18th or 19th of November, and were under
observation in the Infirmary for a day or two, but as they
had no fever and no rash, were sent back from the Infirmary
to the Institution. All these cases desquamated
freely. In two cases the Medical Officer informs me that
there has been reinfection, two girls whose feet were peeling
developing sore-throat, rash and fever. The outbreak
is now at an end, although it is quite possible that isolated
cases may occur.
This still continues to be the most fatal of
all the notifiable zymotic diseases. 162 cases
were notified, and although this shows a considerable
decrease compared with 1897, yet it is an increase compared
with 1896, the number in these two years being
respectively 243 and 98.
Of the 162 cases, 101 or 62.3 per cent. were removed
to hospital where 13 died, and 61 cases were treated at
home with 14 deaths.
The total number of deaths was 27, giving a case
mortality of 16.6 per cent., while in 1897 this mortality
was 20.1 per cent., and in 1896, 12.2 per cent.