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140
because this is a condition which is easily and reliably identified.
Statistics with regard to this defect, therefore, tend to reflect the
true position.
In Greenwich, the 1971 rate per 1,000 total notified births was
1.89 compared with a figure of 0.94 for the previous year.
Mongolism (Down's Syndrome)—This is another reasonably
easily identified defect with a local rate for 1971 of 0.95 per 1,000
total births. The rate for 1970 was 0.93.
In an average year there are approximately 1,300 mongol births
in England and Wales giving a rate of 1.67 per 1,000 live births.
This rate rises with maternal age producing rates of 5.0 and 15.0
for the age groups of 35/39 years and 40 years and over
respectively.
Karyotyping cells by means of amniocentesis is a possible future
diagnostic technique with offer of abortion after the 18th week of
pregnancy.
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 co-operation with the Inner London Education Authority a
scheme was commenced to vaccinate school girls aged 11-13 years
against rubella. It is anticipated that, in future years, this will
eliminate the birth of babies damaged by the rubella virus
acquired by their mothers during pregnancy.
During the year, 2,169 school girls received these injections,
2,078 at school and 91 from their family doctors.
Observation/Handicap Register
Plans to incorporate the "At Risk", Handicapped and Deaf
lists into one composite Register were put into effect during 1968
and its compilation continued throughout the current year. At
present, for administrative reasons, the "At Risk" register remains
separate.
A child with multiple handicaps is listed once, according to the
most severe defect. Statistics can now be obtained with ease and
all children are reviewed periodically by a Medical Officer to
ensure continuing assessment throughout pre-school and school
life. No handicapped child should now approach statutory school
age without having been seen several times by a Local Authority