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only, but not for a sufficient period to cover the infectivity of Scarlet
Fever patients having nose or ear discharge, nor the interval occupied by
the occurrence of intermediate cases. Thus, in two instances, the events
were as follows:—On the notification of a primary case, susceptible contacts
were inoculated. The mothers, however, declined inoculation.
The mothers contracted the disease from the primary cases (presumably),
and the inoculation of the contacts was found to be incapable of protecting
them against the extended period covered by the mothers' illness. Under
domiciliary conditions, where there is prolonged and intimate contact
between susceptible persons and infective persons, passive immunisation
on the scale employed will not prove effectual. But where the relations
are less intimate and less prolonged, advantage may be gained from
passive immunisation of contacts. This is exemplified in the case of a
school where cases of Scarlet Fever were occurring in certain classes with
disquieting frequency. Efforts to identify the infective child, or children,
were unavailing. Resort was had to inoculation of the susceptible children
in the classes affected. About 50 per cent, of the parents consented to
the inoculation of their children attending the classes concerned. These
immunised children were spaced in their classes alternately with the
others. For a fortnight thereafter there was an entire cessation of the
trouble, and subsequently the cases notified as occurring amongst the
children attending this school were in proportion to the cases notified
generally throughout the District. None of the inoculated children
contracted the disease.
The Council has quite definitely adopted the home treatment of
Scarlet Fever as their policy, except in instances where that is precluded
for cogent reasons. The use of the Scarlet Fever toxin, a vaccine of the
organism—or both—as active immunising agents, is the direction that,
at the moment, gives promise of most beneficial results in the protection
of susceptible persons; and with that addition to the armamentarium of
the Public Health Services, the need for hospitalisation of mild cases of
Scarlet Fever would be further reduced.
As an antidote to Scarlet Fever poison, Scarlatinal Anti-toxin is
receiving favour. It is difficult, however, to gauge its efficacy accurately,
since the type of Scarlet Fever now met with is so mild, as a rule; and in
these cases in which serum is administered early—as it should be—and
the patient runs a mild course, it cannot be determined whether the
illness was originally of a mild type or whether the serum modified its
severity. So mild is the ailment as at present seen, that frequently
diagnosis is not made until desquamation appears, and the illness is