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residual paralysis likely to be so severe as to put the child in the class of
" handicapped children " requiring special education. This is a very
fortunate outcome after the early threat of an extensive and crippling
invasion.
The age incidence of the twenty-four confirmed cases is practically
identical with the age distribution of the twenty-one cases which occurred
in the summer of 1947. In both of these outbreaks there was no case
below the age of 1 year. Between ages 2 and 7 inclusive there were
16 cases in 1949 and 15 cases in 1947. Then comes a gap from ages
8 to 14 inclusive in which no case occurred in either outbreak. Both
outbreaks furnished one case at each of the ages 15, 17, 18, 19 and 25.
In 1949 there were three cases over 25 (ages 33, 37, 37). In 1947 one
case occurred over 25 (age 37).
The most arresting feature of this age incidence is the absence in
both outbreaks of any case at ages 7 to 14, although there must be about
7,000 children in this age group in the Borough. No explanation can
be offered of their immunity.
The geographical distribution in the two years 1947 and 1949 was
entirely different. The brunt of the 1949 outbreak fell west of a northsouth
line in the region of Park Road in the centre of the Borough—that
is to say Highgate and Muswell Hill suffered most.
In 1947 the great majority of the cases fell east of this line. No firm
explanation can be given of this or, indeed, of any of the epidemiological
features of this baffling disease. It may be that the eastern half of the
Borough was " salted " or immunised by the 1947 prevalence and so
escaped in 1949. But this offers no explanation of the great variations
in incidence in neighbouring Boroughs, one of which suffered as severely
as Hornsey in 1949, while others escaped with no cases.
Here, then, is a yearly menace to child life and limb and the little we
can do to prevent or control it is summarised in: (1) Don't have your
children's tonsils and adenoids operated on in times of poliomyelitis
prevalence; (2) Avoid physical exertion to the stage of fatigue or
exhaustion; (3) Rest in bed from the beginning of feeling ill—all very
feeble compared with the measures which can be undertaken, with complete
confidence in their success, to prevent such diseases as smallpox,
enteric, diphtheria, etc.
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