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Reference to the table shows that the percentage of home
contacts (of all ages) who developed scarlet fever was slightly less
in the home-treated (1.57 per cent.) than in the hospital-treated
group (1.85 per cent.); but whereas the risk to pre-school contacts
was greater in the case of hospital-treated group, the risk to school
contacts was greater with home treatment.
With regard to the date of onset of secondary cases among
contacts, it will be seen that—except in the adult group—the percentage
of contacts attacked was greater during the first week after
removal of the primary case to hospital than during the whole of
the remaining period of isolation. In home-treated cases, however,
the risk to pre-school children was much greater after the end of
the first week. As regards adults, the risk and the differences are
so small as to be of no statistical significance.
Return Case Rate—After Release from Isolation.
At one time the return-case rate was regarded as an index
of the efficiency of fever hospital administration, and legal proceedings
for alleged negligence have been taken by parents of children
who have developed scarlet fever following the return home of a
patient from hospital. Although the return-case rate may be increased
by negligence and inefficiency, it is now recognised that the rate
remains fairly constant throughout the country. Different authorities
vary widely in their interpretation of what is meant by a
"return case," but the majority regard it as a case of scarlet fever
occurring in a house in which a patient has been released from
isolation within the preceding 28 days. On that basis the following
figures show the comparative incidence of return cases in Leyton
following hospital and home isolation during the last five years.