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64
Dysentery
After the high number of cases in 1956 (579), dysentery notifications
fell to 129. The disease continued to be very mild, being more of a nuisance
than anything else. When it occurs in a school however it does
interfere considerably with education, both of patients and to a lesser
extent of their home contacts. In certain areas where statistics have been
kept it has been found that non-exclusion from school of symptomless
children who have the organism in their stools appears to have no
significant effect on the incidence of the disease. However in the London
area if these positive cases are found they are excluded—normally until
negative. Occasionally a child will go on excreting the causal organisms
indefinitely, or at least for many months, and clearly it would be unreasonable
to exclude the child from school for all that time if satisfactory
precautions against spreading the infection were taken and maintained.
In such cases, if the school authority is willing to have the child back and
if the hygienic conditions in the school are good and the child itself is of
a cooperative age or can be individually supervised, it is allowed to return.
Food poisoning
The number of cases last year formally notified was much the same
as in the previous two years. Formal notification however is not a very
exact indication of the amount of food poisoning in the area and, either
because outbreaks are sometimes so mild as to show only transient
symptoms in the patients, or because of failure of notification, the number
of cases shown in the report is many less than the number of cases actually
coming to the knowledge of the department. Thus we heard of a group
of cases which, on investigation, appeared to have been associated with
the consumption of tinned peas, but these are not included in the numbers
shown in the report as they were not formally notified.
Measles
Measles tends to become epidemic at approximately two-year
periods. If the beginning of the epidemic is in the autumn, then the
number of cases each calendar year tends to even out. If however it
does not really get going until the new year, nearly all the cases occur in
that particular year with correspondingly few in the previous year. This
2-yearly cycle has been the position in Lewisham for about four years
past and, whereas before that time there were usaully some 2,000 cases
each year, since 1953 the numbers have been 500, 3,900, 200 and, last
year, 2,700. Measles remains a very mild disease and in the 2,700 cases
there was no death.
Pneumonia
The number of cases remained about average, which in itself
indicates that there was no great influenzal epidemic during the year.
(Influenza itself is not notifiable). There was much talk and publicity
given to so-called Asian flu during the summer of 1957 and the disease