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ENTERIC FEVER.
Typhold. There was only 1 ease of Typhoid Fever notified
during the year and the diagnosis was doubtful even in this
case, being associated with a vague illness among other members
of the family which was shewn not to be due to Typhoid.
Paratyphoid. Two cases of Paratyphoid Fever were notified as
occurring in one of the mental hospitals, but none in the
remainder of the District.
SCARLET FEVER.
There were 45 notifications of Scarlet Fever received
during the year, and in addition 1 case admitted to hospital as
a case of Diphtheria was subsequently diagnosed to be suffering
from Scarlet Fever. This was compensated for, however, by the
diagnosis not being confirmed in 1 case, which was admitted as
Scarlet Fever.
While slightly more prevalent than in 1941, when only
39 cases occurred, the incidence was still very low compared
with the moderate numbers (6l-7l) occurring each year since
1936. Towards the end of the year increased numbers of cases
occurred in adjoining Districts, tending to overfill the
Isolation Hospital, hence the treatment of cases at their homes
had to be encouraged. Fortunately the disease continued to be
of a very mild type, all cases recovering.
ERYSIPELAS.
The number of cases of Erysipelas notified, 22, was
slightly less than in 1941 (27), the latter being the highest
recorded in this District. Of the 22, one mental hospital
reported 8 cases and the other 4 cases, thus leaving 10 cases
among the general population compared with 4 last year. There
was no association between these 10 cases, only one of which
was admitted to Hospital. All recovered.
DIPHTHERIA.
The incidence of this disease remained at a low level
during 1942, there being only 9 notifications, in one of which
the diagnosis was not confirmed, compared with 7 last year and
25 in 1940. Three of the cases were in adults, one of whom had
been immunised 13 years previously. All the adults recovered.
The question of the efficacy of immunisation naturally arises in
considering these cases but before analysing the 5 notified and
confirmed cases which occurred among children it is advisable to
emphasise two preliminary points, viz:-
1. In judging the efficacy of any treatment, whether curative or
preventive, one must reduce the element of chance by
considering the effect on the largest group of persons treated
rather than generalising on the effects on a small group.
Thus to suggest that the effectiveness of Diphtheria
Immunisation should be judged by the comparatively small
number of individuals concerned in a District such as this
would be folly when statistics are available for the whole
country, The latter are obviously much less likely to be
influenced by coincidence and do in fact show a greatly
reduced risk of contracting Diphtheria following immunisation
accompanied usually by a less severe form of the disease if
and when this is contracted.
2. It must be realised that diphtheria-like germs may be
present in the throat of a person suffering from tonsillitis
without being the cause of the latter. Two cases which
occurred locally in 1942 will illustrate this point. The
first occurred in a part of the District in which a large