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41. Return Cases. There were 30 cases in which infection
was attributed to a patient recently returned from hospital,
compared with 10, 18. 14, and 13, in the four preceding years.
The interval between return of the infecting case and commencement
of illness, in 13 cases, was from three to fourteen days, and
in 12 cases from 2 to 5 weeks. Of the infecting cases, 5 had
some form of rhinitis, on or after their return; 1, otorrhoea; and
1, cough.
The following notice is now sent to the friends of all children
discharged from hospital after scarlet fever, by the Asylums
Board:—
"It is recommended:—
1. That for three weeks after leaving hospital, the patient
should not sleep in the same bed (or, if possible, the
same room) as children who have not had scarlet fever.
2. That during this period articles used by the patient (such
as cup, plate, spoon, handkerchiefs, towels, and toys)
should be kept distinct from those used by other
children.
3. That the patient should not attend school for three weeks.
The above precautions are specially important in the case of
those patients who suffer from Discharge from either
Nose or Ears."
42. Home Isolation. Hospital isolation means much greater
expense, longer isolation, and often the contraction of secondary
infection.
It becomes, therefore, important to inquire whether satisfactory
results are obtained by home isolation. Last year, out of 155
cases isolated at home, 15 were followed by 18 secondary cases in
the same house; of these, however, 12 began within seven days
of notification and were therefore almost certainly infected before
isolation commenced, and would have occurred just the same if