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25
SCARLET FEVER.
Incidence.
In 44 of the 716 patients notified as suffering from scarlet fever, the
diagnosis was withdrawn. The net figure of 672 is an incidence rate per
thousand population of —, a still further rise on the figure for 1942,
which was itself a sharp increase over the rate for the previous years
though lower than the average for the country. Local rates for the
years 1934 to 1942 were 4.70, 3.47, 2.64, 2.31, 2.72, 1.60, 1.06, 1.66, and
3.16.
The incidence for three of the quarters of the year were almost
identical at a weekly average of 14, the rate for the third quarter being
somewhat lower at a figure of 10. The distribution throughout the year
was markedly uniform, in very few of the weeks were there fewer than
10 or more than 20 cases.
Deaths.
No deaths occurred in this district due to scarlet fever.
Place of Treatment.
Of the 672 cases notified, 211 or 31 per cent. were treated at home
at the election of the parents. Of those removed, it seemed another
37 per cent. might have been so dealt with. In 20 per cent. the reason
for removal was the presence of other children at home; in 3 cases there
was no room for the patient to be nursed in; in 7 per cent. the patient
was an adult, and in a further 6 the homes were crowded. In two
instances only was the reason for admission the clinical condition of
the patient.
Secondary Infection.
Secondary infections occurred in 31 households, in three of these
there being 2 cases, in one 3, but in the remainder only one. In 10
instances the original patient was treated at home. On 7 occasions the
onset of illness of the secondary case preceded the removal of the first
patient to hospital, while in a further case the onset was on the day of
removal. Where there was an interval between the removal of the first
case and the onset of the second, this most frequently was two days;
the longest such period was six days.
Return Cases.
Return cases occurred in 14 households, only the one patient being
affected in each home in most instances, but two on two occasions. In
eight cases the interval between the return home of the presumed infecting
case and onset of the return case was under one week; in five the onset
was in the second week, while in one the interval was 26 days. Most of
the return cases were quite normal in appearance, only three showing
any abnormalities; in two of these a nasal discharge had developed,
and in the third a sore nose.