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44
tion of these patients before removal to hospital, the fact that they
subsequently gave rise to infections in the house can only suggest
their having picked up, during their stay in hospital, a more
infectious type of organism.
Deaths.
No deaths were certified during the year as being due to
scarlet fever.
Dick test.
No children were submitted to the Dick test.
Schools.
School attendance again appeared to play no part in the spread
of scarlet fever in this district. Out of 420 cases, only 173 primary
infections occurred amongst children attending the public
elementary schools just prior to succumbing to the illness. There
were very few instances of even two cases occurring in the same
department of any schools in the same week, and in most cases the
interval separating one case from another in the same department
was more than one week.
The distribution of cases by weeks would at first glance lend
support to the suggestion of the effect of schools in spreading this
infection, if the occurrence of a large number of cases occurring
within a short period after the opening of schools after holidays is
taken as evidence of this influence. This was especially marked in
the case of the Easter holidays. The notification figures for
consecutive weeks in late March and early April were, 9, 5, 7, 1.19>
16, 9. The 19 cases were notified up to the end of the week during
which the schools reopened after the holidays. Of these cases,
however, 3 were secondary to preceding infections and one was a
return case. Of the 15 primary cases, 5 were of children under
school age and 2 were of persons over school age ; of the remaining
8, only one attended school during that week, none of the others
having attended since the end of the previous term. Similarly of
the 16 infections in the following week, 10 were of children of
school age but of these 4 had not attended school since the holidays.
This analysis then, discounts the suggestion of school influence
in spreading infection.
Two cases were notified as puerperal scarlet fever. In oneoi
these the onset was the fourth day after the confinement and
appeared a typical case. The other, however, was more probably
a case of a rash occurring through septic infection of the uterus.
Enteric Fever.
No notifications were received during the year of cases of
enteric fever.