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61
The work of the infectious disease visitors as agents of the medical
officer of health includes the investigation of home conditions, the giving
of advice to patients and contacts, particularly where the patient is left
at home, and in general the taking of such measures as may be necessary
to combat the spread of infection.
The following is a summary of the work in visiting infectious diseases
carried out during the year which is in addition to the visits paid by the
public health inspectors referred to in table 25—

Poliomyelitis
In 1959 6 cases of poliomyelitis were confirmed, 2 of them in the
North and 4 in the South divisions. 1 was aged under one year, another
between one and three years of age and two between five and ten. 4
were paralytic and 2 non-paralytic. In order to keep the incidence of
poliomyelitis at a low figure vaccination by injection is essential, though
work is now being carried out on the possibility of using a vaccine by
mouth, which of course would save a great deal of administrative difficulty.
Recent work tends to indicate that in many children the duration
of a satisfactory resistance to the infection after vaccination by three
injections lasts only about two years, and if this is confirmed it indicates
that a fourth injection (which has been advocated for some time in the
United States) should be the rule here. Nevertheless even with three
injections a modified resistance continues for probably a much longer
period.
Dysentery
The total number of cases remained very much the same. The
focus for local outbreaks is often the schools and the mildness of the
type of dysentery conduces to this spread as the child may go on attending
school for the first day or two when likely to be most infective. The
only real bar to the quick spread of the disease appears to be an extremely
high hygienic standard from the very start in connection with
all the apparatus of the water closet and with hand washing; and with
immediate exclusion from school.
Measles
1959 was the epidemic half of the usual two-year cycle, but in spite
of the 2613 cases there were no deaths.