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51
The cases were unequally distributed throughout the year. In the
13 weeks ended April 2nd, there were only 39, a weekly rate of 3. The
weekly rate for the next quarter was 8. This rise was largely due to an
increased incidence in June, the result probably of school infection.
Undue prevalence amongst those in other schools resulted in a heavier
incidence in July, the weekly notification rate for the third quarter
being 6.5. In the last quarter of the year the incidence rose to a level
not reached for a long time in this district, the cases being generally
distributed and not being the result of any special focus of infection.
This was in keeping with the general rise in the incidence of this infection
throughout the country. The average weekly infections for this quarter
were 10.5.
Deaths.
There were no deaths in this district from scarlet fever in 1949.
The last death of a local resident from this disease was in 1940. This
was the case of a baby of 11 months who had been evacuated from here
and who had contracted the infection in his new temporary home. It
is necessary to go back to 1937 to obtain the records of a patient who
died as the result of scarlet fever contracted in this area. Up to that time,
however, these fatalities were not rarities, and in the year 1934, as many
as nine persons living in this area died from this disease.
Place of Treatment.
For many years now many patients suffering from scarlet fever who
have been admitted to the isolation hospitals could quite well have been
nursed at home. In times of unusual prevalence it has on occasion been
necessary to limit admissions, accepting only those for whom there was
some special reason that made it necessary. The most urgent of these
cases were those where admission was necessary because of the clinical
condition of the patient. At one time this might be the severity of
the attack itself, but for many years now the reason would be the development
of complications. Sometimes it was necessary to remove a patient
because the home circumstances were such that the retention of an
infectious patient in the home would cause real risk of other members of
the household contracting the disease. This might arise where there are
many children in the house, or because the house itself was overcrowded
so that isolation could not be practised. Very occasionally removal
to hospital is necessary because if the child remained at home a wage
earner in contact with the infectious patient would be barred from
continuing his employment. Other reasons necessitating admission
are the difficulty of nursing the patient. This might be because he is
an adult, or because the mother has to look after a baby or other small
children. Quite apart from these cases, though, in which removal is
desirable, patients have been admitted to hospital from households in
which it seemed there was little objection to their remaining at home.
In some, of course, removal was asked for because of the apprehension
that if the infectious patient remained at home, some other members
would contract the disease. In most of the cases there was little substance
in this, as so very often the patient is removed to hospital some
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