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been so much in evidence that I am seriously considering a modification
of our present procedure. There is little doubt that dysentery,
particularly the type of dysentery known as Sonne dysentery, has
now taken a firm hold on this country, becoming what is known as
indigenous. If that is the case, and ail available evidence points in
that direction, it is not at all clear that the work which we have
previously carried out in tracing and supervising contacts is fully
justified. I hope to be able to submit a report to the Public Health
Committee during the coming year on the question of dysentery,
which I have to deal with not only as Medical Officer of Health,
but also as District School Medical Officer. Our aim must be to
arrive at a programme which will confine the risk of infection
within reasonable limits, without placing an unnecessary burden
on staff who are already fully occupied. This also applies to the
quite important issue of exclusion from school, a matter in which
we are extremely interested. It seems quite illogical to keep
children who are contacts from school without very good reason.
It is largely in this connection that I propose to amend our present
procedure.
Needless to say, we still propose to exclude adults from work
if they are contacts and if they are connected in any way with
food.
So far as food poisoning is concerned, all cases are carefully
investigated, in an endeavour to trace the source of poisoning and
to prevent spread.
During 1953, all the cases which occurred were sporadic and
did not present themselves as outbreaks. Unfortunately, we seldom
hear of cases of food poisoning sufficiently early to be able to trace
a definite source. If and when we do, the necessary action is taken.
Puerperal Pyrexia
No cases of puerperal pyrexia were notified during the year.
This compares very favourably with conditions which existed not
so long ago, when this disease was not only much more prevalent,
but extremely dangerous.
Smallpox
No case of smallpox occurred in Wood Green during 1953.
For the first time in many years, I was not asked to see any
doubtful rashes.
Mention might be made here of the extremely low vaccination
state of the general population. Although smallpox has not
appeared in epidemic form in this country for several years, there
is always the chance of the Asiatic type of smallpox being imported
in ships or by air transport. We must therefore continue to remain
unsatisfied until the vaccination state has been raised to such a level
as will remove the danger of an outbreak or epidemic occurring.
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