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39. There were nine deaths, giving a death-rate of 0.07 per
1000 population, compared with an average of 0.08 in the five
preceding years, and 0.19 in the ten years 1891-1900. The
death-rate in London was 0.11. The case mortality (proportion
of deaths per cent of notifications), 1.5, was again very low.
It appears from the annual report of the Medical Officer of
Health to the London County Council, that, in the five years
1902-6, only two Metropolitan Boroughs had a lower death-rate
from Scarlet Fever than Woolwich; these were Hampstead and
Stoke Newington.
40. Hospital Isolation—Of the 596 cases, 515, or 86 per
cent. were removed to one of the Fever Hospitals, compared
with 86, 84, 81, 78, and 85, per cent in the five preceding years.
21 cases, of 3.5 per cent, were reported, after observation at
hospital, not to be scarlet fever.
41. Return Cases—There were 38 cases in which infection
was attributed to a patient recently returned from hospital,
compared with 18, 14, 13, and 30, in the four preceding years.
The interval between return of the infecting case and commencement
of illness, in 29 cases, was from three to fourteen
days, and in 9 cases from 2 to 12 weeks. Of the 27 infecting
cases 10 had some form of Rhinitis, on or after their return; 2
otorrhœa; and 1 enlarged cervical glands.
The number of return cases was the highest on record; this
may be partially due to the large number of cases discharged
in the beginning of the year. Of course, it by no means follows
that, because a case of scarlet fever occurs shortly after
contact with a returned case of that disease, therefore
the returned case was necessarily the source of infection.
It may only have been a coincidence. Out of a large number