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none of these was it found that any of the remaining members of the
household had the infection and acted as a link between the two
cases.
Of the secondary cases occurring when the primary case was
treated at home, the onset of the secondary was within one week
of the onset of the primary in 9 instances, within two weeks in
2, and within three weeks in 5 cases. These cases occurring in
the second and third weeks would ordinarily be assumed to have
been preventable by early removal of the primary case. When,
however, the primary case was removed early—and ignoring those
cases where the onset of the symptoms of the secondary case
occurred before removal of the primary infecting source, 16 cases
of secondary infection occurred in whom the onset was within one
week of the removal of the primary, 3 in the second week and
5 in the third. These figures then show that later infections
occurring as secondaries to a home treated case would not necessarily
have been prevented by hospitalization of the primary case.
In most cases there was only one secondary case in the house,
there being two instances of two secondary infections and one of
three. In addition, at the time of the illness of a home treated case,
the mother suffered from tonsillitis in four cases and from quinsy
in one.
Return Cases.
There were 13 return cases in the course of the year, of which
more than one-half occurred in the first two months of the year. No
rases have occurred since July. The distribution of the cases in
point of time confirms the statements made when discussing
return cases in previous years, that the number then occurring
was due to the overcrowded condition under which the hospital
had to be run pending the extension of accommodation.
Eight of the return cases occurred within one week of the
return home of the primary case, two in the second and third and
one in the fourth week. One recovery case occurred in the third
week after the freeing of a primary case.
Some of the infecting cases showed abnormal mucosa developing
a short time after discharge from hospital. Most of the
Primary eases had apparently suffered from an uncomplicated
attack as they were discharged on or about the 28th day. Some
were discharged in their sixth week after admission and one in the
eighth. All had at the onset been at home some days before
removal to hospital, the shortest period being four days from the
onset and most had been removed on the sixth day. Two had been
treaated at home for 10 days before removal and one for 25 days,
""sidering the probable absence of any effective measures of