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69
(1) Diminution in the Death Rate of Scarlet Fever
during the past thirty years is due essentially to the
decreased severity of the disease. The present low level
may be, for any evidence to the contrary, merely the
trough of the wave.
(2) During the period studied no evidence has been
found to prove that hospital isolation has been effective in
reducing the prevalence or mortality from Scarlet Fever.
(3) Although Scarlet Fever has a decreasing
mortality during the past thirty years, there has been no
diminution of prevalence.
Further support to this view is given in the Report
of the Committee on Local Expenditure issued in 1932,
page 89, which states: "There is no reason for prescribing
a routine period of detention in hospital of more than four
weeks in uncomplicated cases of Scarlet Fever.
nothing to suggest an extension of the routine period of
detention has any effect on the number of return cases or
on the incidence of, or mortality from, the disease. We
think that the saving to be secured by adoption of the
conclusion—would be of the order of £120,000 per annum."
"Careful consideration should also be given to the
question whether mild cases of scarlet fever might not be
dealt with at home."
Table IX. in the Appendix of this Report indicates
how the Wards of the Borough were affected by Scarlet
Fever during 1936.
Diphtheria.
The incidence rate fell in 1936 from 0.7 per 1,000
population in 1935 to 0.4 in 1936.
There were three deaths in the 23 cases notified,
compared with four deaths in the 44 cases notified in 1935.
Cases appeared generally to be more severe in type, but
the spread of infection was less active.
Immunisation against Diphtheria has not yet obtained
popularity with the public, and although of proved value
and receiving the support of the Ministry of Health,