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19
of particular micro-organisms. During the last ten years there has been a great
improvement in the treatment of the dehydration associated with this disease ; and
a further hopeful sign is that the specific types of B. coli that are being increasingly
found in outbreaks of this infection are susceptible to the newer anti-biotics.
DIARRHCEA AND ENTERITIS (UNDER TWO YEARS)
MORTALITY PER 1,000 LIVE BIRTHS
Enteric
fevers
Notifications of fevers of the enteric group numbered 66 in 1951 compared with
63 in 1950 ; there were only 4 deaths. In 1900 there were 767 deaths. A number
of the London cases represent infections acquired while the persons were abroad on
the Continent; most of the remainder were the result of infection from healthy
unrecognised carriers. This fact indicates that further reduction in the present low
incidence of these diseases can only result from energetic enquiries in the environment
of known cases with a view to detection of the carrier source. Recent advances in
the methods of detection of enteric organisms in sewage have opened up new
possibilities in the search for carriers. The present interest in the improvement of
hygiene in food premises may be expected to reduce the likelihood of outbreaks of
enteric fever.
Erysipelas
There were 496 notifications of erysipelas in 1951, giving an attack rate of 0.148
per 1,000, compared with 0.167 in 1950. The incidence of this disease has been
declining continuously since 1941. There was one death in 1951.
Influenza

Although there has frequently been laboratory evidence of the presence of the
virus the last major outbreak was in 1937. At the end of 1950, however, influenza
became prevalent first in the north-west of England and later in the south. In
London 704 deaths were registered in the first thirteen weeks of 1951 compared with
146 in the corresponding period in 1950, indicating that an epidemic was occurring.
Epidemic of 1950-51*
Since influenza is not notifiable its incidence must be studied by the weekly
notifications of the various forms of pneumonia and registrations of deaths. A
study of weekly deaths in the great towns of England and Wales, e.g., London,
Birmingham and Manchester in successive winters from 1920 onwards shows sharp
seasonal rises in influenza deaths during most of the winters and since 1919 these
periods of high mortality have not persisted beyond the twentieth week of the year,
the deaths rising rapidly to a peak and then falling away again. The disease does
* Based on a contribution by Mr. B. Benjamin, Statistician of the Council's public health department'
to a discussion at the Royal Society of Medicine. Acknowledgement is made to the Royal Society of
Medicine for permission to use the diagram from page 797 of their " Proceedings " (Vol. 44) 1951.