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are not solely hospital phenomena. They occur after home
isolation. Last year seven "return" cases occurred after
home isolation. One of the latter was somewhat similar to
the case of P. R. G. J. and M. J. were notified of Scarlet
Fever on July 29th and 31st respectively. They were nursed
at home and every care was observed in the isolation of the
patients. They were isolated for six weeks and on the disinfection
of the premises the patients were sent to the seaside.
A few days after their return the servant developed Scarlet
Fever.
It is not fair as a rule to compare home isolation with
hospital isolation, as far as "return" cases are concerned, but
last year the percentage of "return" cases after home isolation
was higher than after hospital isolation.
The wider recognition of the occurrence of “return” cases
has been the means of raising other questions One of these
relates to the length of time during which a person attacked
by Scarlet Fever may be infectious, and in the Annual Report
for 1908, instances were given which showed the tendency of
Scarlet Fever to recur in families and houses after a prolonged
period, and the same feature characterised the disease in 1909.
In 1909 Scarlet Fever was notified in 371 houses, and
during the last four years 1,079 houses have been invaded.
During the year recurrent cases occurred in 110 houses. In 64
of these houses the secondary case occurred within a month of
the removal of the previous case to Hospital; in nine the
recurrent case occurred within a month of the return home of
a patient from the Hospital, and in seven the recurrent case
occurred within a month of the discharge of a patient
home isolation. The remainder, 30, referred to houses from
which a recurrent case was notified after a lengthened
period had elapsed. In 13 of these the recurrent case occurred
amongst members of the same family as the primary one, and
the interval which elapsed between the first and second case
was as follows:—