View report page

50
In the 3 years, 1928-30, following 615 eases treated at home, in
a total susceptible home population of 1,026, there were 13-1
secondary and 16 recovery cases. Of the secondary, at least 49
would not have been avoided had there been ample hospital
accommodation, owing to infection of the secondary having
occurred before recognition of the primary case. Included in the
remaining 85 secondaries arc a large number of cases which were
probably so infectcd, but have actually been classified as preventable
by removal of the primary source.
In the same period of time, 419 hospital treated cases in a
total susceptible population of 1,037 gave rise to 45 secondaries
and 39 return cases. Where a patient commenced home treatment
but was later admitted to hospital, for these purposes he is classified
as a hospital treated case if he caused no secondary infection. If
however, he infected a secondary case and was removed, he is
counted as both a home and hospital treated ease.
In approximately the same number of susceptible population,
84 eases occurred subsequent to the hospital treated primary case
and 101, namely, 16 recovery and 85 preventable cases, secondary
to the home-treated cases. In this area then, for this period,
removal to the Isolation Hospital has played little part in the
prevention of the spread of the disease.
The advantage should be more marked in the future, as the
number of return cases that occurred, undoubtedly, was due to the
difficult conditions under which the hospital has been run for the
past few years. Possibly too, the difference between the effect
of the two conditions of treatment are less marked in this district
because of the poverty of the inhabitants leading the delay in calling
ui the medical attendant, with resulting delay in the isolation of the
patient from the rest of the family. The mild nature of the illness
acts in a similar manner, leading to the delay in recognition and
subsequent isolation.
Deaths.
Five deaths from Scarlet Fever occurred in the course of the
year being a ease mortality rate of 0.97%. One of these, a return
case, has previously been referred to. Two other cases were the
third cases of infection occurring in a house, in each instance the
previous cases being clinically mild. One of these died about the
fourth day from toxaemia and the other, in the third week, from
Pneumonia. One case ascribed to Scarlet Fever was a child with an
apparently mild infection who was treated at home. She sickened
19th September and was freed on 10th November. She was
later admitted to hospital and on the 4th December died, the death
certificate reading " Endocarditis, following Scarlet Fever."