London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1952
[Report of the Medical Officer of Health for London County Council]
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Table 5
Site of paralysis related to period since last inoculation by antigens.
| Period | Same Site | Included site* | Different site | No record of paralysis | Total | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| Same month | — | 28.6 | 3 | 42.8 | 28.6 | 7 | 100.0 | |||
| Following month | 3 | 37.5 | 5 | 62.5 | 8 | 100.0 | ||||
| Second month following inoculation | — | — | — | — | — | — | — | — | — | — |
| Third month following inoculation | — | — | — | — | — | — | — | — | — | — |
| Total | 3 | 20.0 | 13.3 | 3 | 20.0 | 7 | 46.7 | 15 | 100.0 | |
| Same month | 10 | 62.5 | 3 | 18.7 | 1 | 6.3 | 2 | 12.5 | 16 | 100.0 |
| Following month | 8 | 53.3 | 6 | 40.0 | 1 | 6.7 | — | — | 15 | 100.0 |
| Second month following inoculation | — | — | — | — | — | — | 5 | 100.0 | 5 | 100.0 |
| Third month following inoculation | — | — | — | — | — | — | 1 | 100.0 | 1 | 100.0 |
| Total | 18 | 48.7 | 9 | 24.3 | 2 | 5.4 | 8 | 21.6 | 37 | 100.0 |
*Included site means that the site of injection was included in the sites of paralysis.
Inoculation. Thus the excess in the same month is followed by a very much smaller
excess in the second month until in the third month following inoculation the relationship
between observed and expected is reversed. It seems natural to expect that there
would be this kind of inverse correlation since an excessive incidence in the first month
would remove some of the more susceptible children from those at risk in subsequent
months.
Lastly in Table 5 is shown for A.P.T. and the combined antigen separately the
association of paralysis with poliomyelitis of the inoculated cases according to whether
it was in the inoculated limb alone, or included that limb or excluded it. The proportions
shown under the same or included site for the combined antigen are outstanding, 81 per
cent, in the same month and 93 per cent, in the month following inoculation had
paralysis involving the limb in which the injection was given. The evidence is not
nearly so convincing with the A.P.T. prophylactic.
Earlier in this note it was stated that the object was to measure the risk of an inoculated
child being attacked by poliomyelitis. The risk of poliomyelitis without the complication
of inoculation is, at the outset, small, 91 cases in a population of 50,000, or 1 in 550
children aged 9 months to 2 years in the course of a year in which the disease reached
epidemic proportions. The conclusions to be drawn from this investigation are that in
the conditions pertaining in 1949 and over the whole year there was an increased risk—
nearly four times the normal risk in the three months or so following inoculation—of
poliomyelitis following inoculation with the combined diphtheria and pertussis vaccine