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5
Infectious diseases
Tuberculosis, at present the most important of the infectious
diseases, has been dealt with separately above. With regard to the more
acute infections the number of cases of measles dropped (from 2,600 to
1,900), but not to so great an extent as to indicate a return to the prewar
biennial periodicity of this disease. There were slightly more cases
of pneumonia (84 against 67 in the previous year), but 84 is in itself a
relatively small number and can probably be accounted for by the second
mild winter in succession. Poliomyelitis (infantile paralysis) cases
increased from 9 to 35. This number was just about half that of the
peak year 1947, but was of course considerably more than the average
in the early war years and the prewar years. It appears that poliomyelitis
is becoming more endemic and it is also attacking a rather higher age
group. This has often been found to occur in communities which are
fairly well developed hygienically; the reason given being that the
hygienic development postpones the likelihood of infection in infancy,
which otherwise would be the most susceptible time. This in itself is
evidence in favour of poliomyelitis being a disease spread in an
alimentary way (food, flies, dirty fingers and so on), but it remains almost
as true as it did two years ago that very little is known as to the exact
method of spread of this infection. Some interesting figures comparing
1949 and 1947 (both were hot summers) are given in table 37 on p. 56,
and the charts on p. 55. It must be remembered, however, that for every
case of poliomyelitis which is notified there may be 10 to 20 or more other
cases which are not recognised. These are the socalled abortive or
nonparalytic cases and they may be thought to be merely a sore throat,
mild influenza, etc. Particular advice is always given to contacts to be
on the lookout for such symptoms and to take precautions with regard
to avoiding excessive exercise and keeping themselves away from other
people, as it cannot be said in advance whether any particular spread of
infection from a case of poliomyelitis will be of the paralytic or of the
abortive type.
Scabies, a disease primarily of defective hygiene in its widest sense,
again dropped very considerably (from 54 in 1948 to 29 last year) and
this compares with the peak figure of 654 in 1944. Scarlet fever was up
considerably for the fourth year running and there were 520 cases compared
with 332 in the previous year. This was the highest number
since 1943. The disease was however of a very mild type compared with
that of years ago, but this mildness in itself tends to result in an increased
number of cases. The reasons are that cases may be missed, or the
child appears to recover so rapidly that it is not isolated for a sufficiently
long period, or it may not even be isolated at all but continue to go about
by public transport. Whooping cough showed a welcome reduction in
the number of cases, from 789 to 363, but even this number was in
excess of those of several previous years. The number of dysentery
cases dropped from 29 to 9, but dysentery nowadays is usually of a
mild type (the socalled Sonne dysentery) and it is likely that many other
cases occur which are not diagnosed and therefore not notified.
Old people
I have dealt with this increasingly important matter in some detail