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34
would be an advantage perhaps if they also forwarded the
names of children who had suffered from a rhinorrhœa which
appeared to have ceased
It must be confessed that, so far, there has been failure to
deal with this difficult problem, and perhaps there will be until
the germ of the disease is discovered It will be seen presently
that few return cases of diphtheria have recently occurred—
cases of this disease being isolated until the germ is found to
have disappeared
42 Home Isolation Eleven certificates of efficient home
isolation were given to enable men to continue their employment,
compared with 16 in 1908
81 cases were isolated at home None of these was followed
by a secondary case which could be attributed to failure of
isolation There was one ' home return case,' which began 10
days after the first case discontinued isolation
In 1907 and 1908 home isolation was followed by two return
cases and three second cases, due to failure of isolation
Taking the hospital return cases on one side, and the failure
of home isolation and home return cases on the other side, it
may be said that there were, in the three years, 5.4 per cent. of
failures in the hospital isolation, and 23 per cent. in the home
isolation This comparison takes no account of the not inconsiderable
number of children who are attacked at hospital
by a second infectious disease, and the much shorter period of
isolation
43 Other sources of Infection A probable source of infection
was found in 186 cases In 124 cases infection was
attributed to other inmates of the house Some of these were
never notified, and had no distinct symptoms of scarlet fever,