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6. The disease was pretty equally distributed over the
parish. In the early part of the autumn most of the cases
were connected with Bloomfield Road School. Miss English,
the head teacher, called my attention to a female pupil whom
she had refused to admit to the school, suspecting her to have
Scarlet Fever. I visited the house, where washing was taken
in, and found the child to be peeling from Scarlet Fever. I
have little doubt that the mother was aware of the existence
of the disease, but here again as in the cases I mentioned last
year there was no evidence to show that she was aware.
7. The 323 cases occurred in 283 houses; only 27 houses
had two cases, and only 13 houses had three cases. This
shows the great benefits obtained by isolation. In most of
the instances of two or more cases occurring in one house, the
infection has already spread before the disease is notified,
owing either to wilfully or carelessly neglecting to obtain
medical advice in good time. I believe that if the law not only
compelled notification where the householders were aware of
infectious diseases, but also laid on them the responsibility of
making themselves aware, Scarlet Fever might become as rare
as Small Pox. It is no doubt the concealing of mild cases,
and allowing them to go about unnotified that keeps up the
disease.
8. Return Gases.—In six cases the infection was apparently
due to the return of a previous case from the Fever Hospital.
I have examined carefully into these cases, and have formed the
opinion that they are mostly due to the returned case carrying
the infection in his throat. It appears cases may continue to
be infectious for 8, 10, and even 12 weeks. In some of these
cases the throats were obviously unhealthy when I saw them.
I think it would be a wise precaution to recommend the use
of an antiseptic gargle for some weeks after the patient is