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49
Scarlet Fever.
574 cases of scarlet fever were notified during the year. This
is an incidence rate of 6.00 per thousand population, or 14.65 per
thousand population under 15 years of age. The corresponding
figures for England and Wales were 3.21 and 12.34. The comparative
incidence rates of the two groups were therefore 1.87 and 1.09.
The incidence rate was low for the first half of the year, only
in two weeks were double figures recorded. A slight increase was
once more noticed at the end of July and early August. Following
this, the figures fell, to start rising in the second half of September,
reaching a high figure towards the end of October and maintaining
this for the rest of the year, the weekly average for the last 10
weeks being 25.
Reason for Removal to Hospital.
From the middle of October, the accommodation at the
Isolation Hospital was insufficient to meet the demands, and cases
had to be selected for admission. Out of the 292 cases which
occurred in these last weeks of the year, 100 were admitted to
hospital. The reasons for admission were:—clinical condition 30;
difficulty in nursing 36 (these reasons included the following
groups: adult patient, mother expectant, no facilities for isolation,
poverty); exclusion of wage earner 22; risk of infection owing
to large number of children at home 9.
One obtains an impression that the type of scarlet fever is
getting more severe. This impression is to a certain extent
supported by the above figures. In 1930, out of 513 cases, 213 were
admitted to hospital, out of which 40 cases were admitted on
account of the clinical condition of the patient. Actually in these
last weeks of the year, 30 out of 292 not ified cases were admitted on
clinical grounds. In one-third of these the reason for admission
was the severity of the illness; 5 cases went in later with nephritis,
and 5 suffering from ear complications.
Of the 574 cases notified 466 were cases of primary infection,
secondary and one recovery case. There were 17 return cases
and three others in which the case might have been either return or
secondary, in that a third case occurring in the house after the
return home of the infecting ease might be either a second return
case or might be a secondary to the return case.