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Infectious Diseases
Detailed reports follow later but some topics seem worthy of emphasis.
Typhoid notitications over the year numbered 3. Each case necessitates detailed
investigation of cases and contacts. Recent immigrant families have provided
more cases this year than have travellers returning from abroad.One such family
having a typhoid case was found to have travelled during the incubation period
of the disease from Singapore.
A full account is given in the infectious and other diseases section of a
fatal case of pulmonary anthrax in a man working in a local factory, handling
charcoal. The chain of events described demonstrates graphically the need for
constant vigilance in the environmental health field. This case had wide
epidemiological implications which need to be taken up at national, and
international, level. Coincidental with this occurrence, a Ministry of Health
circular recommending an immunisation procedure for anthrax was acted. upon.
Paradoxically, at the factory in question.no worker was willing to be immunised
despite the recent death of a fellow worker. Suffice it to say, that real
prevention based on the "sanitary idea' of nineteenth century pioneers acting at
the appropriate link in the environmental chain will be more efficacious, and
cheaper in the long run in terms of public health,than immunological procedures
offered to volunteers working in what appear to be greater risk sections of an
industry. The natural history and spread of infectious diseases is not bound
by the rules of public health administration.
The department,with many other health departments, continued its co-operation
in the Medical Research Council's investigation into the usefulness and
practicability of types of measles vaccine. A report since published, has led
to proposals in a Ministry circular for schedules of vaccination to selected
groups. At present no proposals under Section 26 of the National Health Service
Act 1946 are being made by this authority. Local family doctors are the best
judges of the need for this vaccine amongst their child patients until further
work clarifies its optimum utility.
A localised outbreak of diphtheria in the Poplar area occurred in the
months of February and March. A child admitted to hospital from an L.C.C.
homeless families unit suffering from measles and chickenpox subsequently
developed a sore throat from which a virulent strain of diphtheria was isolated.
Other positives were then discovered in the unit and at the schools attended by
these patients. In addition some thirty families who had moved meantime from
the unit to intermediate accommodation in the area were found to be infected
with a virulent non-toxic strain. There were in all eight positive cases with
a virulent toxic strain and 29 with a non-toxic strain.
3.