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3°
been faulty or incomplete, it may be due to something which
has been exposed to infection prior to the appearance of the
rash, and not subjected to any form of disinfection.
The following cases are interesting as showing the possibilities
of the early infection of articles that were not subjected
to disinfection. F. N. was removed to the Hospital on
December 17th, 1908, and discharged on January 30th, E. N.,
a sister of F. N., was notified of Scarlet Fever on* January
22nd. E.N. could not possibly have been infected directly by
F. N. unless we assume that the incubation period of Scarlet
Fever extended over a period of five weeks. The more
reasonable explanation lies in the assumption that some
articles infected during the early stages of the disease in
F. N. were not disinfected, and when F. N. was ready to be
discharged from the Hospital these were brought out and
exposed.
A somewhat similar case was the following: A. A. was
removed to the Hospital on December 12th, 1908, and was not
discharged until March 15th, 1909 On March 1st, 1909,
C. A., his brother, was notified. It had been intended to
discharge A. A. in the first week in February, but owing to the
development of a complication he was not discharged until
March 15 th.
More difficult of control is the third class of cases where
the child may return to the home or the school before he is
free from infection. Whether isolated at home or in the
Hospital the patient should have recovered completely before
he is cleansed and discharged from seclusion, but we have no
means of ascertaining whether the patient is absolutely free or
not from infection. It was pointed out in last year's report
that probably the so-called "return" cases are closely related
to those cases which recur in houses after a prolonged period.
It has been usual to regard the two groups of cases as distinct
from each other, and where a case has occurred within a