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41
cases are notified in Woolwich, the death-rate from this
disease is usually lower than in London. The case mortality
(or deaths per cent. of notifications) was 1.3, compared with
2.6, 0.6, and 0.8, in the three preceding years.
39. Hospital Isolation. Of the 626 cases notified, 561
(or 90 per cent.) were removed to one of the Fever Hospitals,
compared with 86, 94, 90, 80, and 88, per cent, in the five
preceding years. 12 cases were reported, after observation
at hospital, not to be scarlet fever.
The percentage of oases 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 31 cases (or 5 per cent,
of notifications) in which infection was attributed to patients
recently returned from hospital, compared with 38, 58, 27,
29, and 37, 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 21 infecting
cases, 5 had some form of rhinitis on or after their return.
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 are recommended
to obtain medical attendance, and the district nurse is