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46
11 of the discharged patients showed no abnormal signs at
the time of illness of the secondary case. In two instances (including
one where the return case was the mother) the interval separating
the return home of the primary to the onset of the illness of the
return case was four to seven days, in five instances (including one
where the mother succumbed) the second week, in three the third
week, and in two the fourth week.
12 presumably infecting cases showed some abnormality, this
being a nasal discharge in five, a sore nostril in three and ear
discharge in one, and tonsillitis or enlarged tonsils in two. In
none of these instances was the interval separating the return
home of the primary to the onset of illness of the secondary case
under one week. In seven the onset was in the second week from
the return home, in two in the third week, and in two in the fourth
week.
Of the 26 patients whose return home was followed by the
occurrence of a further case in the house, two were removed to
hospital on the first day of illness, three on the second, six on the
third, six on the fourth, five on the fifth, one on the sixth, and
one on the seventh, while one was not removed before the ninth
day, and another not before the fifteenth day.
The average period of stay in hospital of the infecting cases
was long, only four patients, of whom three were adults, were in
less than 28 days, eight were discharged in the fifth week from the
onset of illness, two in the sixth, and three in the seventh, while
six were in over eight weeks. These long periods of detention were,
of course, on account of complications, some, such as a nasal or
aural discharge, recurring after the return home of the patient.
Recovery Cases.
One recovery case occurred, the infective patient being isolated
for five weeks and the onset of the illness of the recovery case being
27 days from the release of the primary case from infection.
Home Treated Cases.
140 patients suffering from scarlet fever were treated in their
own homes. Most cases were uncomplicated and made uninterrupted
recoveries. The following is the percentage of incidence of
complications, the figures in brackets being the incidence of
complication in hospital treated cases:—Rhinorrhcea, 4.5 (15.5)
otorrhoea, 3.8 (16.1); albuminuria, 1.5 (6.4); rheumatism, 1.5
(1.8); and adenitis, 0.8 (17.5).
Cases following Operation on the Nasopharynx.
There were five cases this year in which scarlet fever
followed operative treatment of tonsils and adenoids, three at local
hospitals and two at London hospitals. All were of children under
eight years of age. The interval from the operation to the onset
of the illness was three days in two instances, but seven or eight
days in three. One of the patients gave rise to a secondary case.