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16
Smallpox.
On four separate occasions during the year, the Medical Officer of
Health investigated suspected cases of smallpox. Fortunately the
disease was excluded in every case.
On three occasions, information was received that contacts of cases
of smallpox or suspected smallpox were arriving in Westminster. These
contacts numbering 18 were kept under surveillance by officers of the
department until the period of 16 days from the last day of contact was
over.
For some years the first line of defence against the entry of smallpox
into this country has been the Medical Officer at the Port or Airport.
The advent of air travel has introduced new problems by bringing persons
from areas of the world, such as India, where smallpox is still relatively
common, to within one day's travelling time of this country with the
result that they now arrive well within the incubation period of 12 days.
Whereas in the days of sea travel there would be ample time for the
disease to develop and be diagnosed on board or at the port of entry,
nowadays an apparently well person, who is actually incubating the
disease, may enter undetected and develop it days later when he may
possibly have put many miles between himself and the Medical Officer
at the Airport.
The only answer found so far to this comparatively new problem
has been therefore to vaccinate if necessary and keep a close watch
on the movements and health of the contacts until after the 12-day
incubation period is over, usually about 16 days to be on the safe side.
Thus we see how the ever increasing speed of air travel has increased
the importance of this second line of defence which is the province of
the Medical Officer of Health of the area where the contact has taken
up residence.
Lastly, but probably most important of all the defences, is the
vaccination state of the population. The more babies, children and adults
in this country who are or have been vaccinated, the more stony the
ground on which the scourge of smallpox would fall should it by any
mischance be introduced. Any outbreak would thus be halted before
it could get a hold, which would not be the case if the population were
allowed to become unprotected by vaccination. The importance of
vaccination in infancy cannot thus be over emphasised.
Poliomyelitis.
There were 14 notifications of poliomyelitis received during the year.
Of these however, four were subsequently rediagnosed after admission
to hospital as not suffering from the disease, leaving 10 confirmed cases
as compared with one case last year and 28 cases in the peak year in