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the notifications were aged 0-4 years, and the disease continues to be prevalent in day
nurseries and residential nurseries for young children. In a number of outbreaks in day
nurseries an attempt was made to limit spread by sulphonamide prophylaxis using
succinyl-sulphathiazole or phthalyl-sulphathiazole ; while considerable success appeared
to follow the use of the drug in some cases, in others no demonstrable benefit could be
seen.
The investigation into the circumstances of notified cases mentioned in the report
for 1952 continued until November, 1953 and the findings are now being examined.
Enteric fevers
The incidence or typhoid and paratyphoid fevers continued to be low, only 45
notifications being recorded, with an absence of sizeable local epidemics. In some cases
the infection had been acquired abroad, but the majority appeared to be indigenous
infections.
Erysipelas
There were 408 notifications of erysipelas in 1953 giving an attack rate of 0.122 per
1,000 compared with 0.139 in 1952. There were 3 deaths in 1953. If the notifications of
this condition can be regarded as reliable, incidence of erysipelas would appear to have
been declining since 1941.
Food
poisoning

As in the previous year there was a slight male excess in childhood and a female
excess in adults. During July three outbreaks of food poisoning following school meals
in Paddington, Battersea and Camberwell were traced to the consumption of spray
dried milk infected with staphylococcus aureus in the factory. The infected milk was
withdrawn from supply, and from that time spray dried milk has not been used in
school meals unless the prepared dish was a cooked one.
Influenza

Following the ' smog ' at the end of 1952 there was an outbreak of influenza during
the first quarter of 1953. The last major outbreak was during the early months of 1951.
Leptospirosis
Arrangements which have been in operation for many years for the ascertainment
and treatment of leptospirosis among the Council's sewer workers have continued.
Since the end of the war, with the resumption of building work in the sewers, there has
been a slight increase in the frequency of these infections from the unusually low incidence
during the war years. The figure of six confirmed infections during 1953 is the
same as in 1952 and both are comparable with the average figure during the years just
before the war. Occasional sporadic cases in the general public associated with river
bathing continue to occur.