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home from hospital to infect other persons brought into
close relation with them. Obviously, therefore, further
observation on an extended scale is required as to the proportion
of Scarlatina patients in which this streptococcus
Scarlatina is apt to occur, whether in throat secretion or in
nasal discharge, in the post-convalescent stage of their
malady.
"Return" Cases of Scarlet Fever and Diphtheria.
The following is a letter received from the Metropolitan
Asylums Board on the above subject:—
With the view to securing a prompt and reliable report upon all
cases of Scarlet Fever and Diphtheria that may be alleged
to have resulted from the premature discharge of patients
from the Board's infectious hospitals, the managers have
appointed Dr. W. J. B. Simpson, of 14, Oxford Terrace,
Hyde Park, W., to conduct investigations on their behalf
into such cases as may be reported during the six months
commencing on the 1st of October next.
Dr. Simpson has been instructed to conduct his investigations
with the full knowledge and concurrence of, and, as far as
may be practicable, in conjunction with, the Medical Officer
of Health of the District in which the case under investigation
may have arisen; and in view of the important bearing
which the successful conduct of these investigations may
possibly have upon the incidence of infectious disease
generally, and more particularly upon the duration of the
hospital treatment of patients, the Managers trust that you,
in conjunction with the other Metropolitan Medical Officers
of Health, will afford Dr. Simpson every assistance that
may lie in your power.
With this object the Board's Medical Superintendents have
received instructions to place themselves in communication
with yourself, as well as with Dr. Simpson, immediately upon
any alleged "return" case being brought to their notice, so
that no time may be lost in conducting the necessary
investigations, and in tracing, if possible, the probable source
of infection.
It was only necessary to communicate with Dr. Simpson re
one alleged "Return Case of Scarlet Fever," when the circumstances
of the case were duly investigated by him.
Diphtheria.—During the year Diphtheria was very prevalent,
chiefly during April, May and June, at the Newport Market Refuge
School, Coburg Row, nine cases being reported during one
week, and a total of 21 cases was reported during the months