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9
Letters were written to two other medical practitioners
respecting delayed notification. The explanation offered was in
each instance accepted, and no proceedings taken.
I am of opinion that the certificate of the medical attendant
should be the first intimation of the existence of a case of
infectious disease to be received by the medical officer of health,
and that in by far the majority of instances there is no reason
why he should not receive the said certificate within 24 hours of
the practitioner becoming aware of the existence of the disease.
Scarlet Fever.
The total number of cases notified during the year was 162.
There was no great epidemic during the year, but rather a
series of small outbursts, mainly school and house-to-house
infections, with a considerable proportion of secondary cases in
infected houses.
There were 20 cases in the two public institutions in the
district, viz., 6 cases in the Strand Union Schools, and 14 in the
Edmonton Union Workhouse.
53 were secondary cases in infected houses, 2 of them
occurred in a house already infected at the commencement of the
year.
There were 3 houses where 4 secondary cases, 3 where 3,
8 where 2, and fourteen where 1 secondary case besides the
primary case occurred.
Deducting the 53 secondary cases, and the 20 which occurred
in the two public institutions, there remain 89 primary
cases which were notified during the year.
The year opened with two houses only which were known
to be infected with scarlet fever; from neither of these could
infection be definitely traced to have spread elsewhere.
On January 18th a child named Robinson, age 4 years,
developed the disease, and, through family intercourse, communicated
it to another child, who, through attendance at a Sunday
School, communicated it to at least two others. One of these
children, a girl, initiated a large series of cases under the following
circumstances ; She failed on or about January 24th, she