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119
assurance that the organism will not again revert to its virulent strain
and lead to a recurrence of scarlet fever of a severe type.
Place of Treatment
Although very many sufferers were nursed at home, it was felt up
to 1948 when the isolation hospitals were maintained by the local authority
that many children were being admitted to hospital who could have safely
and adequately been nursed at home. In some of these cases there
would have been the added advantage in doing so that the child would
not have run the risk of being exposed to infection by an organism of a
different strain. So few are the secondary cases in households where a
patient is nursed at home which would not have occurred had he been
removed to hospital at the time the disease was recognised that it is
apparent that with the present strain of organism there is little need to
remove patients to hospital with a view to reducing the risk of spread of
infection. Still less is it necessary to admit the child to hospital with a
view to his receiving skilled medical or nursing attention. Since 1948
when the arrangements for the administration of the hospitals changed
there has been a fall in the proportion of patients admitted. Last year
only 36 out of the 212 cases notified were admitted to hospital. In
almost every case this was to the Hendon Isolation Hospital.
Secondary Infection
There were ten cases of secondary infection occurring in six households,
one secondary case occurring in each of two houses, two in each
of four. In all but two of these cases the primary and the secondary case
were notified together so that presumably removal to hospital of the
primary case would not have saved the other patient contracting the
infection.
Return Cases
Sometimes the return home of a patient from hospital to which he
has been admitted suffering from scarlet fever is followed within a few
days by the onset of illness in another member of the family. When this
occurs it offsets to some extent the advantage there is in removing a
patient to hospital to limit the spread of infection. There were no such
cases this year.
Schools and Infection
There were a number of cases in which the pupils at schools seemed
to be unduly heavily attacked with scarlet fever and in which school
attendance might have played some part in the spread of infection. In
spring term cases of scarlet fever smouldered amongst the pupils of
he infants' department of Priestmead school. Over a period of 11 weeks
ther were 11 cases. No one class though was especially attacked.
Over the same period there were three cases amongst those attending
the junior department. Another suggestive series was six cases in six
weeks at St. Joseph's school in the summer term; and yet another, five
cases over five weeks at the Stanmore school in the autumn term. In the
spring term, too, there was a marked incidence of scarlet fever amongst
the Pupils at one of the private schools in the district.