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84
themselves to the risk of infection. There has always been a correlation
between illegitimate births and numbers seeking advice at the
venereal disease clinics but with the changing attitudes to pre-marital
intercourse and the availability of contraceptive knowledge and
measures, in future, this association will tend to be misleading.
Previously, because of the element of 'guilt and shame' in
venereal infections there has always been a reluctance to seek advice
and treatment although this was partially offset by the introduction
of penicillin. Unfortunately, the very success of this antibiotic has
tended to minimise the seriousness of these diseases especially
among the young persons where there is a measure of sexual freedom
undreamt of a decade ago.
Although the Wassermann Reaction had been used since 1906,
it is hard to realise that not until 1948, was syphilis specifically
identifiable. Treatment in the earlier days was prolonged and
painful and patients frequently defaulted before treatment had been
completed. Today, the number of defaulters is considered to bear
some relationship to under-staffing of centres.
Over the years, chemotherapy has been and still is successful
in treating venereal disease although some growing resistance
against penicillin has been recorded. Nevertheless, it is recognised
that drug therapy can never be the complete answer and the problem
remains primarily one of public health.
Despite improvements in methods of diagnosis and treatment
and in epidemiological techniques, anxiety was expressed by the
Ministry's C.M.O. about the increase in national figures for venereal
disease, especially syphilis, during 1965. That his concern was
somewhat too pessimistic has been revealed by the figures for 1966
which show a decline of 14% in syphilis but a slight increase of 2%
in the case of gonorrhoea. In both diseases, however, there was an
increase in female cases but this may well have been the result of
better 'case finding' particularly as in many women gonorrhoea
gives rise to no symptoms.
Prompt tracing of contacts is one of the most important aspects
of control and the Ministry is shortly to produce a circular giving
recommendations intended to strengthen and extend procedures of
contact tracing and to clarify the legal issues involved. Health
education and instruction is another link in the chain of prevention
and control which has the active support of the Ministry of Health
and the Department of Education and Science.