View report page

29
It was pointed out in last year's report that Scarlet Fever
may spread in the early stages of the illness. The disease is
infectious, at any rate in the eruptive stage if not earlier. It
is probable that this early infectiousness accounts for the large
number of secondary cases which occur. It was formerly held
that Scarlet Fever was not infectious until the peeling commenced,
and the secondary cases that occurred in houses
remained unexplained.
Last year 371 houses were affected. In 43 houses two
cases occurred in each, in 12 houses three cases each, in seven
houses four cases each, and five cases occurred in one house
and six in another house.
In 21 instances two of the cases occurred on the same
day, in 15 instances the second notification was received
within a week of the first, in nine cases less than a fortnight
elapsed. and in three instances there was an interval of over
three weeks between the receipt of the first and second notifications'.
In a Majority of these instances the first case was
removed to the Isolation Hospital before the rash had
disappeared. It is difficult to explain the secondary cases
which occur in the above circumstances except on the assumption
that the disease is infectious during its early stages.
There are grounds to believe that the disease is infectious from
the commencement of the sore throat and the initial symptoms.
It is extremely rare for the disease to be introduced into the
same house simultaneously by two persons. In the 21
instances where the two notifications were received on the
same day, one of the children infected the second in the house.
This early infection is consistent with the views now held of
the mode in which the disease is propagated. The infection
probably lies in the throat, nose and mouth. When a person
is sick, the epithleial layer of the mucous membrane is denuded
and the vomit is certain to be infectious. The disinfection of
the premises is often suspected, but, where the disinfection has