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152
1913]
OTHER NOTIFIABLE DISEASES.
Acute Poliomyelitis, Cerebrospinal Meningitis, 0 phthalmia Neonatorum,
Tuberculosis, Plague and Cholera.
Acute Poliomyelitis.
Although only 19 cases, representing an attack rate of 0.06 per 1,000
inhabitants, were notified during the year, yet the disease is of very great
importance, because of the serious results which follow in its train, and,
therefore, it is now discussed fully, more particularly as laymen know very
little about it, and, indeed, it was only in recent years that physicians understood
anything about its methods of spreading and its causation.
Before proceeding to give particulars respecting the Islington cases, it
may be well to say something about its symptoms, etiology or causation, its
mode of spreading, the person whom it attacks, and the means by which it
gains access to the human body.
Symptoms of Poliomyelitis.—Acute poliomyelitis is also known as spinal
infantile paralysis, notwithstanding that it sometimes attacks adult persons,
as it did in one instance in Islington.
The period of incubation lasts at least five days, and usually does
not extend beyond ten days, while its average duration is about a
week. It may evolve in two stages, separated by a period of days or
even weeks, according to Kling and Livaditi, during which the patients
appear to be well, but are capable of conveying the infection. The
attacks generally commence with a slight fever, which may be intermittent
or continuous, while at the same time the frequency of the pulse is increased,
and occasionally a rash makes its appearance. There is usually also a feeling
of drowsiness and malaise. Sometimes the respiratory tract is involved,
and less frequently the alimentary canal. Commonly there is headache and
sometimes vomiting; and there may be catarrh of the nose and throat. The
head may be retracted, due to rigidity of the muscles of the neck, while those
of the spine may be similarly affected. Considerable impatience may be
exhibited by the patient, as well as a desire to be let alone, together with a
distaste of- fondling, due to the fact that a slight touch often causes pain,
which is increased by even a slight movement. Excessive sweating has also
been observed. Paralysis most frequently attacks the lower limbs, and next
in order the muscles of the shoulders. The buttock muscles very seldom
escape paralysis—perhaps once in every three or four cases—and the