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58
The increase in the use of scarlet fever antitoxin may be seen
from the following list showing the number of patients who received
injections of scarlet fever antitoxin during the last five years.
1929 15 cases
1930 10 „
1931 30 „
1932 94 „
1933 217 „
During the period January-July, 1933, some four patients
in the scarlet fever wards developed " relapses " of the fever.
These relapses occurred from 18 to 39 days after admission to
hospital. It was also found that during these months there had
been an increase in the number of return cases, i.e., cases from
homes to which a scarlet fever patient had been discharged within
28 days. On consulting the literature on the subject it was found
that Drs. Burton and Balmain had a similar experience at Ilford,
and were of opinion that the use of scarlet fever antitoxin definitely
increases the liability to relapses. Burton and Balmain also found
evidence that cross-infection with different types of heemolytic
streptococci occurs ; and that these streptococci persist longer in
the throats of patients nursed in hospital than in those nursed at
home. There are those who contend that— in view of these circumstances—
if patients suffering from scarlet fever have to be removed
to hospital, they should be treated in cubicle wards at least until their
immunity can be accurately determined. Unfortunately the accommodation
available for nursing patients in separate cubicles in
Leyton Isolation Hospital is very inadequate and far below the
officially recommended minimum standard ; the result being that
the number of Leyton patients subjected to risk by cross-infection
in scarlet fever wards is much greater than in modern fever hospitals
equipped with adequate accommodation in the form of single
cubicles.