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there were two such deaths in the area of the London Borough of
Greenwich. Already certain common factors have been demonstrated
in the backgrounds of some children who develop malignant diseases.
It is hoped that analysis of the information obtained from these
families will ultimately reveal the manner in which such tragedies
may be prevented.
Respiratory Infections
A surge of pneumonia deaths in the Borough during 1966
focuses attention upon the increasingly serious nature of respiratory
infections.
Nationally, deaths from pneumonia and bronchitis have
increased by 70 % and 11 % respectively during the past decade and
they are still rising. Furthermore, on an average, bronchitis causes
the loss of over 30 million working days per year and is the commonest
reason for consulting practitioners, there being over 26 consultations
per 1,000 patients per year.
Respiratory disease places a substantial burden on the hospital
services. For every million of the population there are 213.3 and
122.5 beds for males and females respectively which are utilised
annually for the treatment of chronic chest infections and these
totals comprise 5.5 % of male beds and 2.5 % of female beds available
for all causes.
With the introduction of sulphonamides in the middle 1930s
and, later, penicillin and other antibiotics, it is true that the severe
symptoms generally associated with the old 'classic' type of pneumonia
have become comparatively rare and the course of the disease
has considerably shortened. Nevertheless, despite improved environmental
conditions, an ageing population is much more susceptible
to chest infections particularly in those instances where there
is financial hardship leading to enforced dietary deficiencies and
restricted home heating. Moreover, diabetes, stroke or cancer, often
the concomitants of old age, also pave the way for pneumonia and,
in other conditions where cytotoxic drugs or cortisone are the
selected forms of treatment, pneumonia can advance insidiously
because of absence of prodromal symptoms.
Infections of the respiratory system, variously diagnosed as
bronchitis, pneumonia, influenza, colds and so on, which constitute
the commonest form of illness in the community, are responsible for
over one-third of all working days and two-thirds of all school
days lost through sickness. In a great many instances, however, the
precise causal organism is never established. While this may be of
little significance in the treatment of the majority of adults, it could
well be of vital importance in the case of young children for, in
Greenwich, some 16 % of our infant deaths arise as a result of respiratory
infections.