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DIPHTHERIA
Hornsey's proud record of freedom from diphtheria was broken this
year by the occurrence of three cases one of which proved fatal A
boy of 11 years of age was admitted to hospital as suffering from a
severe septic throat and he died soon after admission His mother and
two elder sisters were also admitted to hospital the mother being treated
as a carrier and the two girls as cases of diphtheria The diagnosis of
the boy's condition, which was confirmed by post-mortem examination,
was severe faucial and pharyngeal diphtheria with cervical adenitis
These unfortunate cases were all suffering from severe faucial diphtheria,
C diphtheria gravis being isolated in each case The diagnosis
of the elder sister was faucial diphtheria complicated by palatal paralysis
and that of the other sister was faucial diphtheria complicated by mild
peripheral neuritis
Both girls had been immunised but unfortunately the boy had never
received this protection
This sad occurrence gives tragic force to the argument in favour of
immunisation of all children against diphtheria Those cases which
do occur although few in number appear to be of a very virulent type
which has a mortality rate more than twice that prevailing before the
war
The results of the national drive for protecting the child population
are such that the provisional figures for 1954 show 182 notifications of
diphtheria in England and Wales with 9 deaths In 1945 there were
18,596 notifications and 722 deaths
The very success of the immunisation campaign lulls people into a
sense of false security and it cannot be stressed too strongly or too often
that only by maintaining a sufficiently high level of immunised children
can diphtheria be eliminated In last year's report I stated that the aim
is to ensure that at least 75 per cent, of babies are immunised before
reaching their first birthdays
Results for 1954 do show some improvement on previous years but
it is quite impossible to be satisfied when there is still a large child population
unprotected against this most dangerous disease
DYSENTERY
Two hundred and nine cases of sonne dysentery were notified during
the year about half of them occurring in schoolchildren At no time
was it possible to describe the disease as epidemic but the worst months
were January and February when a large number of cases were notified
in the Central Hornsey Ward The outbreak was thoroughly investigated
and was found to be associated with an infants' school in the Ward;
adult patients were usually parents of infants who were first notified
in the family group A number of the children affected did not take
school meals and on investigation the sanitary precautions in the canteen
were found to be impeccable It was considered that the means of spread
of the disease was through toilet accommodation which was inadequate
and fitted with an antiquated flushing system When arrangements were
made to disinfect the toilets twice each day and a drive was made for
better personal hygiene, the outbreak subsided fairly rapidly
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