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clinical condition and later died. One patient developed a mastoid
involvement and was admitted for operation. Another on developing
nasal diphtheria was removed to hospital. The only other
case who commenced home treatment but was subsequently
admitted was removed on account of difficulty of nursing owing
to the mother having contracted the infection.
There were a number of cases of double infection, chicken-pox
occurring simultaneously in five patients, diphtheria in one and
nasal diphtheria in another two, mumps in one, and measles in
two.
In six cases scarlet fever followed removal of tonsils and
adenoids. In three cases the onset of illness was the third day
after the operation, in two cases the second, and in one case the
fourth.
There were nine deaths from scarlet fever during the year,
eight males and one female. In one, however, the death occurred
some months after the illness from " heart failure following
scarlatinal nephritis." A girl of seven died from endo- and
pericarditis. Three deaths were due to extension of ear infection,
a male of eighteen dying of cerebral abscess, one of six and one of
seven from meningitis. Two patients whose illnesses were complicated
by measles suffered from empyema, and one from
pneumonia, and death occurred in a boy of six from septicaemia
and acute endocarditis.
No children were Dick tested during the year.
The few cases of infection appeared to be associated with
school attendance, mostly in schools of the older type of building.
In one infants' department, following the occurrence of a few cases
the school was visited and two children excluded, one suffering
from rhinorrhœa and the other whose hands were desquamating.
A group of cases in another school was apparently due to the
return to school of a missed case who was absent during the acute
stage. No schools were closed on account of the disease, and no
schools or rooms fumigated.
Enteric Fever.
Seven cases of enteric fever were notified during the year.
In each of the last three weeks of July a case of paratyphoid B
was notified, the cases occurring in widely separated parts of the
district, and apparently having no connection in origin. In August
a case of typhoid was notified, the onset being the latter part of
July ; and in the second week of August two nurses of the local
general hospital fell ill, and were later notified as suffering from
enteric fever. In September a boy of sixteen suffered from
typhoid and later died from intestinal haemorrhage. Except for
this last case, the patients made an uninterrupted recovery. Two
were treated at isolation hospitals, the remainder in general
hospitals.