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7
Borough and in the County and I cannot foresee any greater allocation
possible at our present rate of building. Sanatoria are at
full capacity and the waiting time is still lengthy for new cases. In
the report which he has kindly given me, Dr. Jeanes gives some
indication of the extensive home treatment which is organised and
undertaken by him. The figures are impressive and this scheme
constitutes, in suitable homes where there are reasonable facilities
for isolation and attention, a great saving in hospital beds and
nursing labour. It is to be hoped that these endeavours will bear
fruit with the passing of years.
Nevertheless, the time may now be opportune for a reconsideration
of our methods not on a local but on a national level and
calculated on a long term basis. Have the possibilities of B.C.G.
vaccine been exploited with sufficient enthusiasm and resolution?
Is thore any reason why vaccination against Tuberculosis should not
be practised on our infant population as extensively as vaccination
against the Smallpox? What have the Scandinavian countries to
teach us in regard to prevention of Tuberculosis?
It is not within my competence to answer these questions with
authority but they are of some urgency and worthy of enquiry and
perhaps some action.
This year Poliomyelitis reached a high level throughout the
country and in Greenwich there were 32 notifications; of that number
23 were eventually confirmed as true cases, 15 of the paralytic type
and 8 non-paralytic. The table in the body of the Report shows the
age group distribution and the weekly incidence. No deaths occurred.
There was an apparently isolated case in Feburary and it may
be that the virus was already building up in the late winter. We
received our first notifications in May. The incidence increased
throughout June until the peak period in July and thereafter we
had one case in each of the months August, September, October
and November. The cases were scattered apparently at random
throughout the Borough as can be seen from the spot map, but
there were several interesting relationships between some cases,
which have been summarised for convenience in tabulated form.
It is accepted that Poliomyelitis is a communicable disease but
the mode of spread is still obscure. The virus can be found in the
nasal secretion and faeces and in the elucidation of the epidemiology,
all evidence, however tentative and however lacking in case control,
should be submitted for comparison with observations in other
parts of the country. It is in this spirit and with every qualification
that I submit that the case relationships that we have deduced
suggest the following possibilities:—