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49
It will be seen that with the decline in severity and infectivity of
scarlet fever, there lias also been a decline in the number of cases
exhibiting a prolonged or recurrent infectiousness, so far as these have
been ascertained by their association witli "return cases" And this
phenomenon to my mind is of first rate significance.
The "infecting cases" giving rise to "return cases" of scarlet fever
are not improbably the main reservoirs from which, under suitable
seasonal and cyclical epidemic conditions, are drawn the unrecognised
foci of epidemic prevalence.
DIPHTHERIA.
It is not a little remarkable that the year which lias seen a
unique record as regards the prevalence and type of scarlet fever,
should be the year in which the lowest rate of incidence of diphtheria
should also fall to be recorded. The number of cases notified was 166,
the incidence rate 1.1 per 1,000, the number of deaths 11.
TYPHOID FEVER.
Twenty-three cases only of typhoid fever were notified, the
smallest number since the notification Act came into operation. The
fatality rate, 8 7 per cent., is also exceptionally low. So far as Zymotic
diseases are concerned the year has been remarkable.
MEASLES.
The statistical results of enquiries into cases of measles coming to
knowledge as a result of notification by the head teachers of the public
elementary schools, are given in the following tables. 1 do not purpose
to offer any comment at present upon these results.