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The notified cases of scarlet fever show an increase of 6,240 over the number notified in 1912,
due mainly to an increased autumnal prevalence. The disease, however, continues to be mild in type
and the mortality rate is comparatively low. The high incidence of attack is not restricted to London,
but has been observed in Birmingham, South Shields, and other large towns. Dr. Millson says that in
Southwark he has observed that increased scarlet fever prevalence generally occurs in cycles of five years.
The outbreak at the end of 1913 followed on a period of comparative quiescence lasting for seven years,
and Dr. Millson has examined his notifications with a view to learning if the average age of the patients
attacked has increased. He finds that this is not the case in Southwark, and concludes that if a
child escapes scarlet fever up to the age of five years it stands a very fair chance of escaping altogetner.
This question is deserving of more extended study than it has yet received. In Wandsworth special
attention is directed to visiting the homes of child patients who, after recovering, moreover, are examined
by the medical officer of health before they return to school.
The following table shows the notified cases, deaths, case-rates, death-rates, and fatality of
scarlet fever at the several ages and for each sex in London during the year 1913. It will be seen that
at "all ages" the case-rate was highest among females, while the fatalitv was higher among males.
Scarlet fever
cases and
deaths by
age and sex,
London.

It will be seen from diagram (I) that the proportion of cases of scarlet fever admitted to the
hospitals of the Metropolitan Asylums Board was somewhat smaller than in the preceding year.
Scarlet fever
—diagnosis
" not confirmed.