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62
of war in 1939. In spite of the temporary nature of the
structure, the inadequacy of the accommodation, the poor
staff quarters, and the lack of a resident medical officer, the
hospital was not only able to provide most forms of treatment
available in more modern institutions, but valuable investigations
were carried out there. One investigation was instrumental
in drawing attention to the risk of aggregating scarlet
fever patients in multiple-bed wards, in confirming the advisability
of treating scarlet fever patients in separate rooms
either at home or in hospital, and in showing that there is no
increased risk to patients or contacts when isolation is carried
out at home. At one time it was hoped that the segregation
of infectious patients in hospital would help to eradicate these
diseases, but such segregation for that purpose is now known
to be ineffective—and infectious patients are now admitted
to hospital more for treatment than for segregation. It will
be seen from the following figures the great change which
has occurred in the severity of these two diseases since the
beginning of the present century. In order to save space, the
annual figures relate to intervals of ten years until 1940, after
which they are shown yearly. With regard to diphtheria, no
death has occurred in a child who had previously been protected
against that disease by artificial immunisation.
Scarlet Fever Diphtheria
Year No. of cases notified No. of Deaths Case fatality per cent. No. of Deaths. Case fatality per cent.
1900 243 7 2.8 224 28 12 5
1910 551 16 2.9 167 22 13.2
1920 450 5 1.1 354 27 7.6
1930 461 2 0.4 313 12 3.9
1940 87 0 0.0 55 0 0.0
1941 64 1 1.5 44 1 2.2
1942 318 0 0.0 39 0 0.0
1943 386 0 0.0 28 1 3.5
1944 110 0 0.0 24 1 4.1
1945 312 0 0.0 43 2 4.6
It is now known that, in normal times, from 4 to 5 per cent,
of children are healthy "carriers" of diphtheria organisms,
and that the percentage is much higher (as high as 12 per cent.)
when diphtheria is epidemic. These "carriers" are apparently
in good health; they do not show any sign or symptom of
diphtheria, but they harbour in their noses or throats (or both)