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on November 28th. In this instance there was no evidence as to the
primary case (that of Reginald J-) having been infectious on return.
There was a history of " sore throat" in the house during the interval between
the return of the primary case and the occurrence of the secondary
or return case.
(5.) Elsie G-, aged 6, was removed to hospital on October 9th, and returned
home to 77, P- Street, on November 26th. Ada G-, aged
10, who slept in same bed as Elsie, fell ill on November 29th with scarlet
fever. Nothing was observable in connection with Elsie to indicate she
was infectious.
(6.) Alfred B-, aged 2 and 4 months, was removed from 21, Forston
Street, on August 17th, and returned home on November 7th. He is
stated to have had a discharge from his ears when he returned. On
December 5th: Edward O'N-, aged 2 and 8 months, belonging to another
family residing in the house, fell ill and was certified to have scarlet
fever.
(7.) Andrew H-, aged 9, was removed on October 23 and returned home
to 99, C-Street, on December 17th. He was noticed to have a discharge
from' his nose when he returned. On December 25 Johanna
H-was taken ill with scarlet fever. She last attended school on
December 23.
In none of the above cases was there any reason for believing that the measures as
to disinfection were insufficient.
With the exception of the case of Elsie G——, who was taken to the Liverpool
Road Hospital, the patients were removed to the fever hospitals of the Metropolitan
Asylums Board. Assuming that in all the above instances the return cases resulted
through infection from the patients coming back from the hospitals the percentage of
recurrences due to this cause was 2.18, allowing for cases erroneously diagnosed.
Appended to this report is a summary of the return cases of scarlet fever noted in
Shoreditch during the years 1893 to 1903 inclusive. By a "return" case is meant a case
occurring after and presumably due to the release of a patient suffering from the same
disease from isolation, whether in hospital or at home. The person returning from
hospital (which is practically the only means of isolation for a district like Shoreditch)
is here referred to as the primary case, and the case or cases occurring after the return
of the primary case are referred to as secondary or return cases.
From the Summary it can be seen that the total number of instances in which
return cases have been observed amounts to 54, in 20 of which the primary cases were
in males and in 34 females. The incidence of attacks of scarlet fever in the Borough is
greater amongst females than males, but making allowance for this the primary cases
were more frequentlv in females. The secondary or return cases numbered 71, of which
34 were in males and 37 in females. The percentage of instances in which return cases
occurred was approximately 1.4 of the discharges from hospital. The duration of the
detention of the primary cases in hospital varied from 4 to 15 weeks, the average being 9