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59
The distribution was a weekly average of six for the first quarter,
six for the second, two for the third, and five for the last.
51 patients were removed to isolation hospitals; most to the Hendon
Isolation Hospital, but five to others.
Scarlet fever was, even towards the end of the last century, a very
serious disease with a high death rate. Sufferers needed the medical and
nursing care which most could obtain only in the infectious diseases
hospital. For many years now though scarlet fever has typically been
a mild complaint, the sufferers needing little more than being kept to
their beds. Nevertheless, many children suffering from scarlet fever
seemed to be removed to the isolation hospital although they could quite
well have been nursed at home with very little risk of spread of infection.
Even up to 1948 in this district about one half of the patients notified
each year were removed to hospital: in very few of these was the need for
removal the clinical condition of the patient. In 1947, out of 180 cases
notified, 105 were admitted to hospital, 13 of them having to be admitted
elsewhere than to the local hospital. In 1946, 132 out of the 265 notified
cases were removed to hospital. To-day, the proportion admitted is much
lower. In 1951, out of 181 cases only 53 were admitted, and out of 262
notified in 1950 only 69 (of whom 25 were admitted to hospitals other
than the Hendon Isolation Hospital). There was no marked increase in
the number of secondary cases occurring in the households
where the patients were nursed at home. Last year, of the 250 cases
notified, 51 were admitted to isolation hospitals, 46 of these being to the
Hendon Isolation Hospital.
There were 12 households in which secondary cases occurred, only
one in each of 11, two in the other. In four instances, the primary case
was missed. In four others the interval separating the onset of illness
of the primary and of the secondary cases was six days or less, so that
removal of the primary case probably would not have averted the illness
in the other case. In the remaining five cases the interval was 10 days
or more; in these, removal to hospital of the primary case probably
would have saved the other patients in the houses contracting the
infection.
There was only one return case this year. The onset of illness in a
child in the house occurred nine days after the return home of a child who
had been in the isolation hospital suffering from scarlet fever. The child
returning home was well on return, but developed a sore throat and discharge
from the nose.
In one instance a child developed scarlet fever shortly after having
his tonsils removed.
Some groupings of cases amongst pupils of schools suggested that
school attendance might have been a factor in spread, though on each
occasion there were only a few cases and these, though in the same school
department, were mostly in different classes. In the Spring term, there
were six cases spread over three weeks amongst the pupils of Greenhill
School; and five cases spread over two weeks in the Infants' Department