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34
It appears from the Annual Report of the Medical Officer
of Health to the London County Council that in the five years
1905-9 only seven Metropolitan boroughs had a lower deathrate
from scarlet fever than Woolwich.
39. Hospital Isolation. Of the 474 cases, 420 (or 88 per
cent.) were removed to one of the Fever Hospitals, compared
with 85,86, 94,90, and 80, per cent. in the five preceding years.
7 cases were reported, after observation at hospital, not to
be scarlet fever.
The percentage of cases removed to hospital was again
very high. A large proportion of notified cases are removed
to hospital, not because they cannot be sufficiently isolated
at home, but because the parents cannot afford the cost of
medical attendance and nursing. Much might be saved to
the rates if there was power to provide this at the public cost.
40. Return Cases. There were 37 cases (or 8 per cent, of
notifications) in which infection was attributed to patients
recently returned from hospital, compared with 30, 38, 58,
27, and 29, in the five preceding years. The interval between
the return of the infecting case and commencement of
illness varied from three to 27 days. Of the infecting cases,
10 had some form of rhinitis on or after their return, 2
otorrhœa, 1 sore throat, and 1 measles.
As a rule, the children returning from hospital are quite
well at the moment of leaving, but in many cases develop
some nasal discharge on arriving home, or within a few days.
Illustrative cases of this were given in the 1908 Report.
The parents of all children with any discharge arp recommended
to obtain medical attendance, and the district nurse is