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59
Return Cases.
There were 12 instances of one return ease occurring in a house
after the return home of a scarlet fever patient after a period of
detention in hospital. In 3 other instances there occurred a subsequent
case in the home, the patient having been infected cither by
the patient who returned from hospital, or as a secondary to the
return ease infected from that source—and in 2 instances two
such subsequent infections occurred, in each case there being
three patients infected after the return home of the original case.
60 per cent of these patients contracted their infections in the
months April to July. The intervals between the time of the
return of the infecting patient and the onset of the return case was
under one week in 7 cases, one to two weeks in 5, and two to three
weeks in 4 cases. In nearly one-half of the infecting cases there
was a history of a nasal discharge appearing subsequent to the
return home of the patient, and in one case a history of otorrhoea.
The infecting cases had been home varying periods of time
before removal to hospital in the first instance. No case was
apparently removed before the second day ; 4 were removed on the
second, one on the 3rd and four on the 4th day. Two cases had been
at home a period of 2 to 3 weeks as missed cases before being
removed to hospital, without apparently giving rise during this
period to any infection. In one instance the return home of the
child was followed bv one, and in the other by two cases. Another
child who was not removed until the 5th day of his illness had
caused no infection before removal, but his return was followed
by the occurrence of three cases, the same thing happening in
another instance where the child was removed on the second day.
Serum Treatment.
The following notes are abstracted from the report of Dr.
E. James, Medical Superintendent to Rush Green Isoation
Hospital
"Scarlet fever anti-toxin was given intra-muscularly to most
of the eases admitted during the second half of the year; approx
imately 75 per cent received 30 c.c. and most of the remainder
20 c.c. A few had 40 or 50 c.c.
The following is a percentage list of the complication rates in
274 serum treated and 226 non-serum treated cases, the latter
being admitted during the first half of the year :