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18
SCARLET FEVER (SCARLATINA).
The cases of scarlet fever certified during 1905 numbered 789, as compared with
343 in 1904 and 255 in 1903. In 18 of these or 2.3 per cent., intimations were received
from the Metropolitan Asylums Board that the patients were suffering not from
the disease certified, but from some complaint which was not scarlet fever, the diagnosis
in 7 being erythema, in 3 tonsillitis, in 2 pneumonia, in 4 it was influenza, bronchitis,
measles, and diphtheria respectively, and in 2 no obvious disease was recognised. The
corrected number of cases was therefore 771, as compared with 320 in 1904 and 237 in
1903.

Of the cases certified, 766 or 97 per cent. were removed to hospital for treatment
as compared with 96 per cent. in 1904. The percentages for previous years are given
in the report for 1903. Notwithstanding the high percentage of cases removed for
isolation and the measures taken as to disinfection, the disease throughout the year
until the beginning of October, manifested a marked tendency to spread from family
to family in the Borough. This was more apparent than for several years past, and
undoubtedly one of those years when scarlet fever tends to become markedly epidemic
has been passed through. It is impossible to say what proportions the epidemic would
have assumed if there had not been such a large amount of isolation effected, but it
is highly probable that the cases would have been more numerous by several hundreds.
An important factor in the dissemination of infection was missed cases. Thirteen such
cases in the peeling stage of the disease were certified by myself, having come under
notice whilst making enquiries where local prevalence of the disease had attracted
attention. In these eases no medical men had been called in, the friends appeared to