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6
to deal. It is a very costly disease to cure and every avenue should be
sought to prevent its spread and to control its incidence.
Newer methods of treatment are prolonging the life of the tuberculous
person and there are suggestions that in due course immunisation may
enhance resistance to the disease. In the end, however, the main
factors which will control its spread and prevent its incidence are better
housing and environmental conditions and a good adequate wholesome
diet. Satisfaction with our low infantile mortality rate is only justified
if at the same time we realise the problems of the aged and the
possibilities of preventing tuberculosis.
During 1950 there were notified 14 cases of poliomyelitis (infantile
paralysis). This compares with 25 cases in 1949. Research into the
causation and method of spread of this disease is being pursued and it
is hoped that a time will not be far away when further knowledge will
bring us near to its prevention and cure. I think we ought to realise
that the public fear of poliomyelitis is out of proportion to the actual
number of cases that are being recorded. It is true that in 1947, 1949,
and 1950, the number far exceeded that of previous years and the fear
has been expressed that we are likely in the future to have to contend
with this disease as a more frequent occurrence than in the past. This
may be possible, but it is, after all, only speculation. Many cases,
moreover, are mild and are not complicated by paralysis in a recognised
form, whilst of the remainder who do develop paralytic symptoms, the
majority make a complete recovery.
At the time of writing this report there is some indication that the
number of cases is increasing, though they are certainly less than in the
corresponding period of 1950. I am often asked what steps should be
taken to avoid poliomyelitis, or to minimise the risks of paralysis.
Generally, there is no need to take any particular precaution unless there
are definite indications that a considerable number of cases of poliomyelitis
are occurring in the district. Under such circumstances crowded
places should be avoided, and children and young adults should not
become overtired by strenuous competitive exercise or late nights. Food
should be protected from contamination, the hands carefully washed
after using the toilet, and on any sign of minor illness rest in bed is
advisable, for it has been suggested that undue exertion during the
early days of infection may increase the risk of paralysis.
With all this it is as well to keep a sense of proportion of the risks
involved. Road accidents killed 6 times as many people as did
poliomyelitis in the big epidemic of 1947, and maimed 35 times as many.
There is a very happy contact between the Public Health Department,
the local hospitals, and the London County Council for consultation as
to any further steps that might be taken should the number of cases of
poliomyelitis be unduly heavy.
The value of the Public Health Department is best assessed by an
indication of the use the public make of it. During 1950, no less than
2,311 complaints were made as to nuisances which might be remedied
with the assistance of the Public Health Department. Every one of
these complaints was carefully and fully investigated by your Sanitary
Inspectors and where the complaint was found to be justified and one
capable of being dealt with by a local authority the appropriate steps
were taken to secure the abatement of the nuisance. During the year
it will be seen that 1,530 intimation notices and 436 statutory notices
were served. It was only in 11 cases that we had to ask for a summons.