View report page

49
rhinitis in varying degree (one of these had also otorrhcea, one earache and enlarged glands, one
epistaxis, 2 enlarged glands, one sore throat, one sores about the face, and one a septic finger);
6 had sores about the face ; 4 had otorrhoea (one of these had also nephritis); 2 had enlarged
glands ; and one had epistaxis. The remaining 21 were considered to show no signs of infectiousness,
though a number of them had enlarged tonsils.
Swabs from the nose or throat (or both) were taken from the (?) infecting cases in some
instances, and the cultures from them examined in smears for the B. diphtheriae in the ordinary
routine manner, chiefly at the Lister Institute. 15 cases were examined in this way with the
following results Nose and throat both " positive," 4 ; nose " positive " (throat not swabbed),
3 ; nose " negative " (throat not swabbed), 7 ; nose and also a swab from the ear " negative "
(throat not swabbed), I. In every case swabbed there was rhinitis.
In 5 instances the return of the original case of scarlet fever was followed within 28 days
by a return case or cases of that disease, and also by a case of diphtheria in the house. Three
of the above-mentioned " positive " results (N +T +, N + T and N +) were obtained in
these instances, no swabs being taken in the other two instances.

Scarlet fever after diphtheria.—There were also 5 instances in which a case of scarlet fever
developed within 28 days of the return from hospital to the same house of a previous case of
diphtheria. In each of these only one case of diphtheria had returned within that period. In
one instance the diphtheria case was in the same family as the scarlet fever case, and in 4 instances
in a different family in the same house. In one case the diphtheria convalescent showed nasal
discharge (negative swab) and sores about the mouth, and in one other some injection of the
throat; the others were not regarded as showing evidence of scarlatinal infectiousness. The
intervals between the return of the diphtheria case and the onset of the case of scarlet fever were
4, 11, 18, 23 and 25 days. The return cases took their onset in March, April, May, July and
December respectively.
After-Care.
A proportion of the children who have been discharged from hospital after scarlet fever
have been visited to ascertain their condition and to secure treatment for sequelae if necessary;
839 such children have been visited in 1922, of whom 682 are reported to have recovered
satisfactorily and 157 to have required treatment. The conditions needing treatment were as
follows* :—Nose and throat, 42; debility, 35; ears, 33 ; cough or " chest trouble," 13; kidney,
11 ; enlarged glands, 8 ; rheumatism, 8 ; eyes, 6 ; heart, 5. Thirty-five of the cases were treated
at the St. Pancras Dispensary, 56 at hospitals, 11 at the school clinics, and 44 by private doctors.
Scarlet Fever at the Foundling Hospital.
An outbreak of this disease, serious from the point of view of numbers, occurred at the
Foundling Hospital in 1921-22. There were 140 cases in all; 56 in the Boys' Department,
70 in the Girls' Department, 10 in the Infants' Department, and 4 in the resident staff. Fortunately,
the cases were of very mild type, and there were no deaths. The total population of
* Some of the patients suffered from two or more complaints.
(7947)
G