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5
decrease which customarily occurs every other year contains the
first fruits of the vaccination campaign begun in 1968 but hampered
by shortage of measles vaccine in 1969.
Immunization is a major weapon in the armoury of preventive
medicine. Fresh testimony to its lasting value as a protective
measure in infancy and childhood can be found in the body of the
Report in relation to the detection, isolation and treatment of nine
carriers of dangerous diphtheria bacilli and to the investigation of
their numerous contacts : thanks to the high level of immunity in
the neighbourhood concerned no clinical cases occurred. Hence
the importance attached to the completion early in life of an
immunization schedule designed to provide protection against—in
addition to diphtheria—such potentially serious infections as
whooping cough, tetanus, poliomyelitis, measles, tuberculosis and
german measles (rubella). The introduction of measles vaccination
two years ago has already been mentioned and it is gratifying to
report that in Wandsworth in 1970 more than twice as many
children were vaccinated against this tiresome disease as in the
previous year (3,703 compared with 1,686). In the autumn a new
immunization programme commenced aimed at protecting girls
between the ages of 11 and 14 against rubella, priority being given
initially to the 13-year-old age-group; by the end of the year 151
girls had been immunized. It is difficult to overstate the importance
of this venture, for it will forestall the potentially disastrous situation
which may otherwise arise later in life whenever german
measles is contracted during pregnancy to the grave peril of the
unborn child ; severe congenital abnormalities may handicap the
survivors. Another welcome development in 1970 was the opportunity
to take part with a leading pharmaceutical concern in a
clinical trial of a new oral poliomyelitis vaccine. The search for
ever more effective immunizing agents is a quest meriting the
strongest support. Similar research in the past followed by intensive
immunization campaigns has meant that some of the serious
infectious diseases have dwindled almost to vanishing point, but
this must not be allowed to dim public recognition of the continuing
need for specific prophylaxis. Rare diseases are unlikely to be
recognized quickly and an unprotected population can be very
vulnerable in this context. Diphtheria—mentioned earlier—and
poliomyelitis illustrate this point well; both continue to demand
our profound respect. In short, complacency must be avoided like
the plague.
Cholera was the disease which, arriving in Europe and invading
these shores, led to the appearance on the local scene in this
country of the medical officer of health and the inspector of nuisances.
Successive epidemics in the first half of the nineteenth
century were correctly associated in the public mind with the gross
insanitary conditions of the times. An appropriate sense of urgency
launched the great era of sanitary reform in which the emphasis was