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4
arterial disease, bulk very large as causes of death; this is a subject
to which I have devoted attention in previous Reports and I
need not dilate upon it again.
During 1968, 1,280 confirmed cases of infectious disease were
reported in comparison with 3,344 in 1967, the decrease being due
to the drop in the incidence of measles, since 1968 was not a
"measles year Details concerning infectious diseases are to be
found in the body of the Report.
In 1968, immunization against measles was commenced and by
the end of December a total of 1,657 children had been immunized,
624 by general practitioners and 1,033 at our own clinics. One
must consider what effect, if any, this comparatively small number
of immunized children may have had on the incidence of measles.
Comparisons are difficult from one year to another because of the
recognized biennial increased incidence of the disease. The year
1968 was not a "measles year" so that to make a reasonably valid
comparison we must go back to the previous " non-measles year
which was 1966; in fact in the last quarter of 1966, 725 cases of
measles were notified whereas in the last quarter of 1968 there
were only 398 cases notified. In other words, there were slightly
more than half the cases of measles in the last quarter of 1968
than in 1966. The same trend is to be seen in the early part of
1969 compared with the similar period in 1967. Whether or not
this reduction can be attributed to the measles immunization undertaken
in 1968 cannot, at this stage, be definitely assessed since there
are other possible explanations but the trend is certainly interesting
and will be carefully watched.
In June, 1968, infective jaundice became notifiable and 56 cases
were brought to our notice during the remainder of the year. All
these were followed up and investigated with reference to possible
causative factors. Particular attention was paid to the connection
between injections and jaundice with the possibility of linking
cases of jaundice with illicit injections of drugs but little of interest
was detected.
The year opened with a case of typhoid fever in a nurse at one
of the large hospitals in the Borough. In investigating the source
of infection a widespread survey was carried out among the staff
of the various establishments that the nurse had recently visited
to take refreshment. Similarly, her own nursing associates and the
patients she looked after were investigated and altogether 331 persons
were screened without the source of the infection being ascertained.
Soon after this investigation was completed, a second case
of typhoid fever was reported by another London borough arising
in a technician recently arrived in this country from West Africa
who worked at the hospital referred to above and although a
further 97 persons were examined, no link was established between
the infection in the technician and that in the nurse.