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With regard to those admitted to hospital, in 11 instances
the patient was an only child. (In 3, or possibly 4 of these cases
the adult members of the family were associated with food handling
or some occupation making the child's admission to hospital
desirable, but in at least 7 instances there would appear to have
been no special reason for their admission.) It is interesting
also to note that in the 59 cases in which the patient was admitted
to hospital, there being other brothers or sisters in the home,
there were 3 occasions on which secondary cases occurred within
a few days of the commencement of the first case, hospitalisation
as such, therefore, being too slow a measure to prevent a second
case. In addition, in 2 instances after the discharge of the
original case from hospital, one or two of the other children
in the home contracted the disease, all 3 of these "return" cases
being admitted to hospital, presumably on account of other
children still in the house.
From these and similar observations in preceding years, it
appears that, unless there are physical complications requiring
special nursing, or special domestic reasons such as overcrowding
both parents working, or either of them involved in food handling,
there is no justification from the point of view of the
prevention of the spread of the disease for the admission of
cases of scarlet fever to hospital at the present time.
It is only in about one in ten of these infections that secondary
cases occur in the house, and the chance of these occurring
is not greatly reduced by the removal of the original case to
hospital, especially when the subsequent risk of "return" cases is
taken into account.
As in almost all instances at least one other member of
the family can be assumed to be infected, though not necessarily
showing any symptoms, or at any rate not developing a
rash, the only criterion worth serious consideration in deciding
whether a case shall be admitted to hospital is whether physical
or domestic complications make admission very desirable.
Unnecessary hospitalisation should obviously be avoided
in view of the risks of cross infection for the patient, the absorption
of bed space and nursing manpower which might be otherwise
utilised, and the cost to the community.
ERYSIPELAS.
Only 4 cases of erysipelas were notified during the year,
this being the same number as in 1949. All were treated at
their homes and recovered.
PUERPERAL PYREXIA.
Two mild cases of puerperal pyrexia were notified, this
being the average for recent years. Both recovered without
being removed to hospital.
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