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July (1) and October (2). The relative mildness of this infection is reflected
in the fact that only 9 of the 15 cases were notified by practitioners, the
remaining 6 coming to notice in other ways.
Scarlet Fever
The changing nature of this infection is evidenced by the experience of
this disease in the past years. For a number of years, scarlet fever has
become progressively milder in character and attended by a much lower
degree of morbidity and mortality. At the beginning of the century, cases
of septic scarlet fever were not uncommon and resulted in not a few deaths.
Today the illness mostly runs a mild course and complications are rare.
For these reasons the precautions which are advised for patients and
contacts have been markedly relaxed. Schoolchildren are now allowed to
return to school after only three weeks in uncomplicated cases and there is
no automatic exclusion from school of the domestic contacts. Whilst this
relaxation of restriction is entirely justified by the altered conditions, it
should be remembered that scarlet fever is still an infectious illness and
precautions are still of value in limiting the spread of the infection.
The number of notifications received during the year at 27 was by far
the lowest yet recorded and is less than half of the previous year's total
which itself was a record low figure at that time. Whilst there is no doubt
that this represents a true reduction in incidence there is some evidence
that because of the mildness of the clinical illness a number of cases failed
to be notified. Of the total, 19 were nursed at home and 8 were admitted
to isolation hospital.
TABLE 10.