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103
Mongolism—This is another reasonably easily identified defect
with a local rate for 1969 of 1.50 per 1,000 total births. Rates for
England and Wales and the South East Region for 1968 are 0.77
and 0.83 respectively.
Rubella Vaccination
Congenital defects arising as a result of an attack of rubella
during the first trimester of pregnancy are well known. On an
average, one in every six children born in these circumstances is
likely to suffer from such defects.
In Britain, it has been estimated that major epidemics occur
at intervals of 8 to 10 years (the last in 1962) during which about
1,500 women could be expected to contract rubella and, of these,
some 500 cases would arise within the first three months of
pregnancy. In a non-epidemic year, figures might be as low as 500
and 100 respectively. Small epidemics are likely as often as every
6 years and outbreaks tend to be more prevalent in winter and
spring.
Recent investigations carried out in the Home Counties reveal
that approximately l/3rd of all girls would not have developed
immunity to german measles by the age of 15 years. Because so
many girls in the 15/20 age group are potential mothers, it is
extremely important that protection be given them at an earlier age.
Under the control of the G.L.C.'s Research and Intelligence
Unit, a trial of rubella vaccine on girls of 11/13 \ years in the
I.L.E.A. area has recently been carried out, the results of which
could well determine local health authorities' future prophylaxis
policy regarding this mild but foetus-damaging infective virus.
Between 35,000 and 40,000 children born in Great Britain every
year have congential defects requiring medical treatment of which
between £ and l/3rd need special educational assistance.
A recent investigation based upon a continuing study of 17,500
births occurring during the first week of March, 1958, has shown
that these births derived originally from about 21,000 conceptions
of which some 10% miscarried as a result of chromosomal or
structural abnormalities. Of the 21,000, 10% had severe anomalies
arising in early pregnancy but almost 2/3rds did not survive to
7 years. A further 2% died around the time of birth but without
detectable malformation.
Congenital mental defects were most common—defects in 2
children out of every 1,000 were so severe as to exclude them from
any school and they were either attending a training centre or
receiving no education at all. Further, one child in every 1,000