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Excluding measles and whooping cough, which were not notifiable
in the years between the wars, and cases occurring in the mental
hospitals, it is found that the incidence of infectious disease in the
District generally was only 1.8 cases per 1,000 population in 1945, which
is slightly less than in 1938, in which year the incidence was one of the
lowest for pre-war years.
Diphtheria.
During the seven years 1939-45, there were 92 notifications of diphtheria,
but of these eight were found not to be suffering from the disease.
The more definite cases were distributed as follows: 7 in 1939, 24 in 1940,
followed by 7, 8, 6, 19 and 15 in 1945. It should be noted, however,
that in the last two years the majority of the cases (i.e., 15 and 12) have
occurred among the adult patients and staff of one of the mental hospitals
in an outbreak which appeared to die out during the first six months of
1944, following passive and active immunisation, but, with the admission
of new patients, continued to produce cases sporadically throughout
1945. If the cases thus occurring among a relatively self-contained
community are excluded, it is interesting to note the contrast between
the 31 cases among the general population in 1939-40, and the 26 cases
which occurred in the five years 1941-45 after the extensive immunisation
of the child population which was achieved in 1941 and improved upon
in later years.
In 1939-40, 58 per cent. of the cases were among children, whereas in
1941-45 only 10 cases (38 per cent.) occurred in childhood.
The tendency for an increasing proportion of the cases to occur
among adults, and particularly among teachers (two cases in 1945) and
nurses ( two in 1941 and others in the mental hospitals since), emphasises
the desirability of immunisaion, if they are not already negative to the
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