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32
Scarlet fever—Proportion of cases and deaths in hospitals.
It will be seen by reference to diagram IX. that while in 1896 a somewhat larger proportion of
the London cases of scarlet fever were admitted into the hospitals of the Metropolitan Asylums Board
than in 1895, the proportion of deaths occurring in these institutions was very slightly smaller.
Scarlet fever, 1896—Age and sex distribution.
In the following table are shown the age and sex distribution of the cases of scarlet fever
notified in London during the year 1896, together with the deaths and case mortality at each age. As
in preceding years males at all ages were attacked and died in greater proportion than females, and
the case mortality of males was greater than that of females. The greatest incidence of attack was on
children four years of age in the case of both males and females. The greatest incidence of death was
on males of four years of age, and on females of three years of age. At most ages the case mortality,
both of males and females, was lower than in 1895.

Scarlet fever—Seasonal variations in fatality.
In my last annual report I published tables and diagrams showing that the statistics of 1892-5
gave strong indications of definite seasonal fatality, that is to say, that the highest seasonal fatality
occurred in the early months of the year, and that the fatality declined generally in succeeding months
until a minimum was reached in September or October, after which fatality increased. Correction
made for difference in age and sex distribution of the cases of each month supplied reason for thinking
that these differences were insufficient to account for the variations shown in the fatality. There was
some arrest of the fall in the month of August, a result no doubt due in the main to the fact that
schools are closed at that time, leading to the fatality being calculated more largely upon children of
early life whose fatality is high.
I supply in this report the figures of the year 1896, and of the period 1892-6, which it must be
observed are uncorrected for differences of age and sex distribution. The figures of the additional
year give no reasons for different statement of the subject (see also " Diphtheria," page 40).

* In the preparation of this table, the question whether the persons, who were attacked and who died, belonged to London is
disregarded, the percentage being calculated on the number of cases notified in London, and the number of deaths occurring in London
and the institutions belonging to London. Inasmuch as the age of the patient is not in all cases recorded in the notification certificate,
it has been necessary to distribute such cases among the various ages proportionately.