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Immediate recognition of the disease presents many difficulties, as although there
are certain characteristic features of the typical and severe attack, experience has taught
that this fever may and does appear in milder and anomalous forms, and which lead to
its being mistaken for other ailments of more common occurrence in this country.
Unfortunately failure to recognise Cerebro-Spinal Fever is apt particularly to
happen when the malady is of the "fulminant" variety, in which case death
ensues rapidly.
The examination of the Cerebro-Spinal fluid withdrawn from the lower part
of the spinal canal by lumbar puncture, affords a valuable aid to diagnosis. The
Corporation have therefore undertaken the bacteriological examination of the fluid for
the diplococcus of Weichselbaum, and the City Medical Practitioners have been so
informed.
Only one case, i.e., a child age 21/2 years, has occurred in the City since this
disease was made notifiable.
The Local Government Board have under consideration the desirability of
including the above disease in the list of notifiable Infectious Diseases.
NOTIFICATION OF ACUTE POLIO-MYELITIS OR ACUTE
POLIO-ENCEPHALITIS.
Acute Polio-myelitis, a disease of acute or sudden onset, commonly occurring in
young children, and often confused with Cerebro-Spinal Meningitis, was first made
notifiable by the London County Council in September, 1911, who by virtue of the
powers conferred by Section 56 (6) of the Public Health (London) Act, 1891, made an
Order requiring for a period of six months its notification within the administrative
County of London.
This Order was extended indefinitely in March, 1912, and failure to notify
cases of Acute Polio-Myelitis or Acute Polio-Encephalitis renders the offender liable to
a penalty not exceeding 40s.
The disease is most prevalent during the months of July, August and September,
and chiefly attacks children during the second and third years of age.
Although there is evidence that the disease may be carried by a non-infected
person, it can hardly be classed with the highly infectious diseases, as many persons
are known to have lived in close contact with patients and altogether escaped infection.
In epidemics, however, isolation has been found of considerable value in limiting
its sphere of influence.
Beyond the fact that the disease is infectious, little appears to be known as to how
such infection is conveyed, and although the water-supply, food, domestic animals, &c.,
have been suggested as responsible agents, no circumstances have yet been proved that
can thus definitely attach the responsibility. Again, some cases appear to have been
due to personal contact, but many have occurred where all these possible sources can
be eliminated.