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separating the onset of illness from the date of operation were 5,
6 and 8 days.
Deaths.
Two deaths were registered as being due to scarlet fever.
One was that of an adult female who was operated on for an
acute abdomen, the certificate reading "streptococcal septicaemia,
scarlet fever, laparotomy." The other was a child who developed
an abscess some weeks after having recovered from scarlet fever
and died from failure of a congenitally malformed heart.
Dick Testing.
Apart from those tests carried out in the isolation hospital
for diagnostic purposes no provision was made for Dick testing.
Schools and Scarlet Fever.
Only 174 of those cases notified were children who, prior to
succumbing to their illness, were in attendance at a public
elementary school. In 75 cases the patient was the only person
in attendance at school who suffered from scarlet fever at that
time, the onset of illness in any other child who attended the same
department being separated from that of each of these cases by
an interval of at least 10 days. In a number of other cases there
was little to suggest that school attendance was responsible for
the infection. Two cases occurred in the same department of a
school during the same week but with the preceding and succeeding
weeks both free on 8 occasions, and three cases occurred similarly
once. Single cases in two consecutive weeks occurred six times
and 3 cases distributed over two or three weeks on three occasions.
There were only five groupings suggesting that school attendance
was responsible for the spread of infection. In one infants' department
7 cases over three weeks and some weeks later 4 cases in
each of two consecutive weeks occurred. In another infants'
department 6 cases occurred over three weeks, and in a third 5 over
two weeks. One school department had cases smouldering through
the summer and the autumn terms. Altogether in 30 school
weeks 42 cases occurred in this department, some weeks being
free and only on one occasion there being as many as four cases.
In the summer term the brunt was borne by two classes, though
in the autumn term the infection was more widespread throughout
the department.
Period of Residence of Patients Notified.
Of 401 patients notified as suffering from scarlet fever 10 had
lived in the district less than one month; 11 had been here over
one but under 3 months, 17 over 3 but under 6 months, and 35
over 6 but under 12 months. 36 had been here over 12 but under
18 months, and 14 over 18 months but under 2 years. 63 were
in their third year of residence, 53 in their fourth, 44 in their fifth
and 118 had lived here over five years.