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49
the two cases were 35 and 30 days. Of the others, the onset of the
second ca.se was within five days of clcarancc in three eases, whilst
in the other two the intervals were 12 and 23 days.
Of the cases treated at home, very few probably arc genuinely
isolated for the whole period and most arc probably as serious a
source of infection before as after the disinfection of the premises.
In many, the first ease was not diagnosed for a number of days
after onset. In two out of the number which gave rise to recovery
cases, the diagnosis was not made in the ease of the primary for 11
and 16 days. Probably for this period they mixed with the others,
except possibly for the few days at the time of the acute illness
of onset.
Considering, in relation to home treated cases, those cases
where another infection occurred subsequent to the diagnosis of
the first case, the following numbers of cases occurred in succeeding
weeks from the onset ; within 7 days of onset 8, and in the succeeding
weeks 4, 5, 3, 2, 2, 2.
These figures again suggest that the most infectious period of
Scarlet Fever infection is for a number of days in the neighbourhood
of the onset; and that after that, infcctivity in most cases is very
slight but a few cases remain infectious for a period up to 7 weeks.
Comparison of Home and Hospital Treatment.
As many secondary infections occur before the recognition of
the primary case and therefore would occur whether or not the
primary case were removed to hospital, the comparison is made
only between the return eases following on hospital treatment, nd,
in relation to the home treated patients, those secondary cases
which would probably have been prevented by early removal of
the primary and also the recovery cases.
There were 17 return cases occurring in 100 houses in which
there were, apart from the infccting cases, 373 children under 15
and 366 adults:
Subsequent to 219 primary cases treated at home, there were
29 preventable secondary cases and seven recovery cases in a child
population of 250, and an adult population of 523.
These figures this year, show an advantage in the removal to
hospital of the first case. This is less marked, however, if to the
cases infected by hospital treated primary eases are added that
number (14) of secondary infections which occurred despite hospital
removal of the primary case.