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23
It may be that not all the 10 instances referred to carried the
infection with them back from the hospital and that infection may
have come from some other source. In this connection it is not a
very rare occurrence for a second case to occur in a house 3 or 4
weeks after the first case was removed to hospital, and before
it has returned again, and when all the usual precautions of disinfecting
and cleaning have been observed. Still, the close connection
between the discharge of a patient from hospital and the occurrence
of another case leaves no doubt that in a proportion the infection is
carried by the discharged patient.
It is much to be regretted that this source of infection cannot
be removed, and our experience last year shows an increase rather
than a reduction from this cause.
The following statement summarises the essential particulars
of the return cases referred to:—
(1) Case No. 179 was discharged from hospital on January 1st,
1920, A sister developed Scarlet Fever on January 25th,
1920, eight days after the return of the supposed infecting
case. A maid in the same house also developed Scarlct
Fever on February 20th. The doctor who notified the priginal
case on re-examination, certified the child had nasal discharge
and precautions were taken accordingly, but this
did not succeed in preventing the spread of infection.
(2) Case No. 188 fell ill on May 19th, 1920, was removed to
hospital the same day and discharged cured on June 24th.
Re-examined by the Doctor on return from hospital and certified
free from infection. The mother fell ill with Scarlet
Fever on July 11th, 1920, 17 days after the return of the
supposed infecting case.
(3) Case No. 107 fell ill on June 6th, 1920, removed to hospital
June 22nd, and discharged July 31st, 1920. The Doctor
re-examined the patient on August 5th, 1920, and certified
"free from infection." On August 11th another case of
Scarlet Fever occurred in the house.
(4) Case No. 1 fell ill December 29th, 1919, removed to hospital
January 1st, 1920, and discharged July 7th, 1920. Seven
days later another case occurred in this house. The