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12
INFECTIOUS AND OTHER NOTIFIABLE DISEASES
The Public Health (Infectious Diseases) Regulations 1968, which came into operation on
1st October, 1968, caused changes and additions to be made to the list of diseases in respect of
which Medical Officers of Health should be notified; acute primary and influenzal pneumonia,
acute rheumatism, erysipelas, membranous croup and puerperal pyrexia are no longer notifiable,
whilst leptospirosis, tetanus and yellow fever are now required to be notified. Infective jaundice
had been added to the list earlier in the year. Furthermore, all existing regulations relating to
notification and prevention of infectious disease were consolidated into one instrument; and by
an order made under Section 50 of the Health Services and Public Health Act, 1968 the notification
fee payable to all medical practitioners was increased to five shillings from 1st October, 1968.
Irrespective of these changes, the incidence of infectious disease in the City continued to be at
a low level. Notifications received (excluding tuberculosis) decreased from 1,400 in 1967 to 671,
of which measles accounted for 253.
Table 3, page 80, gives details of notifications received and the age groups concerned.
Acute Poliomyelitis and Diphtheria
No cases of these diseases occurred in Westminster in 1968.
Dysentery
Twenty-seven notifications of dysentery were received, compared with seventy-nine in the
previous year. The majority were single unconnected cases.
Infective Jaundice
The Public Health (Infective Jaundice) Regulations 1968 came into operation on 15th June
and by the end of the year 61 notifications had been received.
Measles
The number of measles notifications dropped from 1,098 in 1967 to 253 during 1968.
Puerperal Pyrexia
Puerperal pyrexia ceased to be notifiable from 1 st October, 1968 but up to that date 86 notifications
of the disease had been received, thirty-eight of the patients being persons normally resident in
Westminster. During the previous year 88 cases were notified, 43 being residents.
Table 5, page 81, shows an analysis of the causes of pyrexia in the cases notified.
Smallpox
During the early part of the year under review the first full-scale smallpox alert since the
amalgamation of the Boroughs in 1965, occurred in Westminster.
The patient, a Pakistani boy of 15 years, travelled alone from Karachi to London Airport (Heathrow)
and proceeded to an address in Kensington where he stayed with relatives. The day after his arrival
he visited friends at an address in Wardour Street, Westminster. Two days later (Tuesday), because
he was feeling unwell, the boy was taken by these friends to the surgery of a general practitioner
in the Soho area where he received treatment. Although there was no eruption when he was
first seen by the general practitioner, shortly afterwards the patient developed a rash and he was
again taken by his companions to the same doctor who immediately informed the Medical Officer
of Health. One of the City Council's Medical Officers and a smallpox consultant at once visited
the boy at the house in Wardour Street. The diagnosis of smallpox could not be ruled out and the
boy was accordingly removed to Long Reach Hospital, Dartford, Kent. Cultures were submitted
to Colindale Laboratory and a positive diagnosis was made on the following Sunday morning.
Although the patient had only been in the country for some four days, he had been in contact
with 36 of his compatriots at the address in Kensington and with over 100 persons in Westminster.
All were traced by the public health inspectors within a day or two, vaccinated by the medical
officers, and then kept under daily surveillance for 17 days. Dealing with these contacts was
made more difficult by the fact that few of them could speak English. Fortunately, two members
of the Health Department clerical staff were able to act as interpreters for the duration of the alert.
Many of the contacts worked in the catering industry in the West End and did not finish their