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cases of Scarlatina—and for this reason that the sufferers convey
typical Scarlatina to others.
In the absence of this close association with an obvious.
Scarlatina, abortive cases are sure to pass unrecognised, on
recovery mix with the public, and failing the onset of desquamation
and its discovery, they escape detection.
A diagnosis of a typical case of the disease is not easy
even for the expert. Thus one child I have in mind, a convalescent
in the Whooping Cough Ward of the Evelina
Hospital for Children, had a Scarlatina-like eruption localised
to the chest and a temperature of 99° F. It was seen by
various members of the Medical Staff there, and the concensus,
of opinion was that it was not Scarlatina. But is was Scarlatina
for a child in the next cot contracted the disease from it.
This is not an isolated experience, and it is obvious that cases
where the signs are not distinctive are extremely likely to pass
unrecognized. Therefore when dealing with a case of obvious
Scarlet Fever at an infected house, it is advisable that medical
enquiry should be made in relation to these matters to which
I have just called attention, and that the medical practitioners
of Beckenham should be invited to make observations in relation
thereto, and report their results to the Sanitary Authority
on the usual terms.
That abortive cases should be isolated is an obvious deduction.
To mention other phases of the behaviour of the disease:
—Contact with Scarlet Fever patients by unprotected individuals
may be of the freest possible kind, extend over a
long period of time, and yet the contacts escape the disease.
But should their general health suffer in any way, even though
a considerable time, perhaps months, have elapsed since the
last exposure to infection, they arc likely to develop Scarlet
Fever. Thus a child may have been freely exposed to infection
in a Scarlatina Ward and escape the disease, but
under the home regime and lowered vitality in sequence to
poor food and unhygenic environment, the child succumbs
and the complaint runs a typical course. Or quite