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52
Most of the infecting patients gave a history of being apparently
well on their return home, but after a few days developing a nasal
discharge. In three instances, two return cases occurred in the
same household, the onset of illness of each of the pair being the
same date.
The period from the time of return home to the onset of
illness was unusually long in most cases. In two instances it was
on the 5th day after return home, and in five it was the 7th day.
The onset was in the second week in 4 instances, and in the 3rd
week 6, of which 5 were on the 20th day.
Although in most cases the primary patient was removed
early to hospital, in two instances removal was not effected until
the 4th day, and in one each the 5th, 10th and 15th days. This
last patient, after a period in hospital of 28 days, on the 7th day
after his return home, infected two cases.
This year too, the average period of detention in hospital was
longer, presumably on account of complications. Although a few
were discharged after less than 28 days in hospital, no patient
was discharged within 28 days from the onset of the illness.
Actually in five instances the infecting case was discharged from
hospital in the 5th week from the onset of illness; in one instance
the 6th; in four the 7th; and in one each the 8th, 10th, 11th
and 12th weeks.
Infectivity of Scarlet Fever.
In the case of 27 secondary infections where the primary case
was removed to hospital, the time from the onset of illness of
the primary to the onset of illness of the secondary was under 7
days in 18 instances; was between 8 and 15 days in 8 instances;
and in only one case was the period longer than 15 days. These
figures do not represent the actual periods of incubation of the
disease, as included in this list of cases are some in respect of whom
the primary infecting case, while removed to hospital immediately
on notification, owing to slight delay in diagnosis was not sent
in on the date of onset—in fact, removal of the primary ease
on the actual day of onset of the disease was comparatively rare.
Ihe primary case would therefore in most instances have been at
home one or more days before removal. In these circumstances,
the actual time of infection would range over this period. Where,
however, cases had to be detained at home for many days, even
though eventually removed, they have been included in the other
list.