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There is no doubt whatever that children suffering from
nasal or ear discharge after Scarlet Fever are a very definite
danger, and during 1925 there have been six " return "
cases after discharge from Isolation Hospital.
Therefore, I think it must be assumed that all the above
modes of spread are contributory to the almost constant
occurrence of cases of Scarlet Fever.
The majority of the cases occur among the poorer
classes, and are admitted to the Isolation Hospital; but
when cases can be satisfactorily isolated, they are nursed
at home. Those kept at home seldom give rise to secondary
cases, and as a rule do very well.
All bedding, etc., is subjected to steam disinfection in
a Velox Disinfector on removal of cases to hospital or after
recovery at home. The rooms are disinfected by means of
a formalin spray and formaldehyde vapour.
School contacts are excluded for a fortnight, and places
of work notified in respect of patients and contacts.
Special care is taken to exclude contacts from Sunday
Schools, and laundries are informed of the occurrence of a
case of infectious disease at the house of a customer.
The Dick Test has not been used, or any artificial
method of immunization employed.
DIPHTHERIA.
There has been a somewhat remarkable diminution in
the incidence of Diphtheria during the past three years,
which is difficult to explain, and it is much too early to
prophesy that this low figure is likely to be permanent.
It will be remembered that the last epidemic of Diphtheria
occurred in the year 1919, during which 142 cases
were reported, and this was followed by 80 cases in 1920.
There was an outbreak of Diphtheria at St. Paul's
Girls' and Infants' School in 1921, ten cases being notified
between September 13th and 20th.
Swabs were taken from 24 girls in Standard II, with
the result that one positive and one very suspicious swab
were found.
The carrier, suspicious case, and four contacts were
excluded from School until two negative swabs had been
taken from each.