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infections, or whether the later ones were secondary to the first
of the return cases. In two of the cases where two were affected
the onsets were simultaneous, occurring on the sixth and tenth
day after the patient's discharge from hospital. In such a case the
returning patient will have infected both. It is probable also that
he will have done so in the home where his return on the 5th day
of the month was followed by the onset of illness in another member
of the household on the 14th; subsequent to the removal of this
patient on the 15th, another succumbed on the 25th. In a similar
instance, the patient returned home on the 19th January; on the
2nd February a brother fell ill and was removed on the' 4th; the
onset of illness in the other patient was the 21st February. This
interval was therefore 17 days from the removal of the first of the
return cases, but 34 from the return home of the first patient in
the household.
Of the remaining cases, the first patient returned home on the
24th January, the onset of illness in the next member was the
29th and his removal to hospital the 31st; the other patient fell
ill on 2nd February. The particulars of the last case are that the
patient, removed to hospital on the 8th February, was discharged
on 10th March, apparently well; on the 11th March another child
in the household fell ill with scarlet fever, but was not removed
until the 18th ; on the 22nd the third patient fell ill.
There were two instances where a return case followed on the
return home from hospital of one who had himself been a return
case.
Home Treated Cases.
111 patients suffering from scarlet fever were treated in their
own homes. These cases are visited frequently by the fever nurse
where visits are welcome. Most were mild in character, two-thirds
being uncomplicated and making an apparently uninterrupted
recovery.
Adenitis occurred in 11 per cent., being slightly commoner
in its onset in the second than in the third week of illness. This
figure compares with that of 12.7 per cent. for those patients treated
in hospital. Otorrhoea occurred in seven patients, the onset being
limited to the first and second weeks. Two of these patients were
later admitted to hospital on account of suspected mastoid involvement.
Rheumatic pains occurred with far more frequency in the
home treated cases, being present some time during the illness of
14 per cent., the onset being mostly in the second week, with a
slightly smaller number in the first, and few in the third week of
illness.
Two patients, brothers, who commenced home treatment were
subsequently removed to hospital on account of development of
mastoid infection.