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Scarlet Fever.
139 patients were under treatment at the beginning of 1930,
and 694 cases, notified as scarlet fever, were admitted during the
year. Of these, 24 cases were found on admission to be not suffering
from the disease, and in 47 other cases the diagnosis remained
doubtful. Six of the latter contracted the infection in the wards.
Four patients whose diagnosis was confirmed on admission had a
relapse during the third week of illness.
A scarlatiniform rash, of varying degrees of intensity, was
present in 61 per cent. of the cases on admission, 9 per cent. were
desquamating on admission, and 23 per cent. desquamated later,
but in 7 per cent. no rash or desquamation was detected during
residence. The average duration of illness of all cases on admission
was 5.68 days.
During the year 723 cases were discharged recovered, 1 died,
and 85 remained under treatment at the end of the year. The
fatal case was a child, aged 1 year, who was suffering from the
septic type of the disease. The fatality rate was .11 of the cases
discharged. Scarlet fever antitoxin was administered to 27 cases ;
the average dose was 15 c.c.
In 44 of the cases discharged the disease was complicated by
the presence of other infections as follows :—
Scarlet Fever with Nasal Diphtheria 15 cases.
,, ,, ,, Faucial Diphtheria 6 ,,
,, ,, ,, Measles 9 ,,
,, ,, Mumps 2 ,,
,, ,, ,, Chickenpox 4 ,,
„ ,, ,, Erysipelas 2 ,,
The incidence of nasal diphtheria among the scarlet fever
patients showed a definite decrease as compared with the previous
year. This vear 7 cases were suffering from nasal diphtheria on
admission, and 8 developed rhinitis with positive swabs during
convalescence, whereas last year 11 cases suffered from nasal
diphtheria on admission, and 26 developed positive nasal swabs
during convalescence. The decrease may have resulted from the
immunisation of all the Schick positive cases which was carried
on during the year, but, on the other hand, it might have been due
to the fact that both diseases tended to become milder during the
course of the year. Further experience is necessary on this matter.
Complications : Of the 723 cases discharged during the year,
226, or 31.25 per cent., suffered from complications as follows:—
Adenitis 38 cases or 5.25 per cent.
Albuminuria 44 ,, ,, 6.08 ,, ,,
Nephritis 9 ,, ,, 1.24 ,, ,,
Arthritis 16 ,, ,, 2.21 ,, ,,
Otorrhoea 49 ,, ,,6.77 ,, ,,
Rhinitis 25 ,, ,, 3.45 ,, ,,
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