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40
PUERPERAL PYREXIA.
Thirty-nine notifications were received, of which 33 occurred in
institutions.

During the year under review there occurred the most
widespread epidemic of scarlet fever since 1943. Fortunately the
disease was of the mild type to which we have become accustomed
during recent years; and of the 332 persons notified to be suffering
from scarlet fever, only 86 were removed to hospital. The very
mildness of the prevalent type of illness has made it one of the most
difficult of infectious diseases to diagnose. If the infection is accompanied
by a scarletiniform rash, it becomes an officially notifiable
infectious disease necessitating the putting into operation of certain
traditional methods of control. If, however, the same infection—
and the same causative organism—gives rise to disability (e.g.,
epidemic sore throat) without a typical rash, no official action is
called for, although the patient without the rash is equally—and
possibly more—infectious. Such a bewildering state of affairs is
tending to bring into disrepute the regulations for the notification
of infectious disease and for the exclusion from school of contacts
from infected households.