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for discharge from the Hospital. It is understood that the article
referred to are those that have in some way come in contact with the
mucous discharged from the patient.
The other 16 cases will not allow of this explanation. Even
allowing the most liberal margin for error, the occurrence of recurrent
cases in these 16 houses in one year cannot be explained on the
ground of mere coincidence. Not only is the number too high, but
the conditions under which some of these occurred, were not favourable
to the recurrence of Scarlet Fever. In 3 instances there were
no persons under 20 years of age in the house.
The theory has been advanced " that in a small minority of
cases, Scarlet Fever may remain infectious for a very long period.
It does not follow that such cases are continuously infectious
during this time. All the facts seem to indicate that continuous
infectiousness is not a feature of Scarlet Fever." Dr. Butler read a
paper on this subject before the Epidemiological Society in November
1908, and emphasized the following three points.
1. Under varying but occasionally recognisable conditions,
persons recovered from Scarlet Fever are capable of conveying
the infection to others after intervals frequently of prolonged
duration, when apparently they had ceased to be infectious.
2. There are persons who have not suffered from the
disease who appear to harbour the infection in their tissues in
such a manner that while t here is no ground for considering them
during this passive stage a danger to others may yet, by a
critical lowering of their resistance, become the source of their
own infection.
3. There are others again, of whom, while it would be
incorrect to say they had suffered from an attack of Scarlet
Fever, have yet in some degree reacted to an invasion of the
poison and are capable of communicating to those with whom
they come in contact the disease to which as such they are
themselves immure.
These matters are of great epidemiological interest and three
instances may be given which seemed to indicate that it was
something in the persons attacked and not in the buildings which
was determining the persistence of the infection.