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18
officers of health and 4 through the co-operation of the school care committees. In
addition, the school medical service from time to time reports on the condition of
school children suffering from the after effects of encephalitis lethargica; at the end
of the year there were 36 children under such supervision in the schools.
A review of 191 cases of post-encephalitis lethargica was made to endeavour to
obtain some information as to the interval elapsing between the acute attack of
encephalitis lethargica and the first appearance of the sequelae. The forms of application
for admission to the special unit at the Northern hospital contain two questions:
(1) "When did the attack of epidemic encephalitis occur?" and (2) "When did the
sequelae of the attack make their appearance?" The information contained in the
following statement was obtained from the answers given to these questions:—
Age groups
0-5
6-10
11-15
16-20
21-30
31-40
41-50
Over 50
Number of cases under review
18
27
35
46
34
21
8
2
Number of cases where
sequelae followed directly
on acute attack
14
13
17
25
19
12
4
2
Number of cases where
sequelae followed under a
year from onset of attack
1
2
4
2
5
1
3
_
Number of cases where
sequelae followed the acute
attack after an interval of
1 year
2
1
2
6
4
4
1
-
2 years
1
3
2
5
2
1
-
-
3 „
-
4
3
4
1
-
-
-
4 „
-
-
2
1
-
2
-
-
5 „
-
-
1
-
1
-
-
-
6 „
-
3
1
-
-
-
-
-
7 „
-
-
3
-
1
-
-
-
8 „
-
-
-
2
1
-
-
-
9 „
-
-
-
1
-
-
-
-
10 „
-
-
-
-
-
1
-
-
11-13 „
-
1
-
-
-
-
-
-
Poliomyelitis
and polioencephalitis.
It will be noted that in about 45 per cent, of the cases the sequelae were stated
not to have appeared until the lapse of variable periods up to 10-13 years after the
acute attack.
Notifications of poliomyelitis and polioencephalitis numbered 74; the diagnosis
was not confirmed in 9 of these. Of the 65 actual cases, 4 proved fatal. In addition,
8 deaths were recorded by the Registrar-General of cases which had not been notified,
and 1 of a case which was notified in 1933, making a total of 13 deaths. Particulars
of acute cases admitted to the Council's Western hospital and of cases admitted
when convalescent to the Council's Queen Mary's hospital for children, Carshalton,
for treatment of crippling effects of the acute stage, are given in Vol. IV (Part I)
of this report.
Serum
treatment
of acute
anterior
poliomyelitis
In my last annual report, I referred to the scheme whereby the public health
department of the Council have co-operated with the Ministry of Health, the Medical
Research Council, and the Lister Institute, in arranging to maintain a stock of poliomyelitis
immune serum with a view to its use in the treatment of infantile paralysis.
The serum is obtained voluntarily from donors who have recently suffered from an
undoubted attack of the disease and all batches of serum are tested for their protective
properties at the Lister Institute before issue. Since the inception of the scheme in
1932, there has been a steady demand for the serum; it has only been possible to
maintain an uninterrupted supply by restricting its employment to acute cases in
the pre-paralytic stage of the disease, or in which the paralysis tends to spread, and
by securing the co-operation of practitioners in returning unused serum as expeditiously
as possible.