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Diphtheria
A fall occurred in the number of notifications of diphtheria from 16 in 1955 to 11
in 1956. No considerable outbreaks took place. Of the two deaths registered only one
resulted from an attack of diphtheria during the year, this being in an unimmunised
child of four years of age. The other was a woman of 59 who died from heart disease
which it was thought resulted from diphtheria some years ago. The continued occurrence
of cases of this disease underlines the necessity for keeping up the highest level of
immunity in the population by immunisation of young children and the giving of
booster doses at school entry. This is particularly important in a large centre of population
such as London which is always open to the danger of imported infection.
An interesting change that has occurred in recent years is the reduction in the number
of notifications of diphtheria in very young children. Only two of the eleven notifications
in 1956 were of children under the age of 5 years.
Dysentery
In common with the rest of the country London experienced in 1956 the highest
incidence of dysentery since the disease became notifiable in 1919—half as high again
as the previous highest total in 1954. Since 1919 there have been three periods of
increased incidence, the first in 1937-38, the second from 1943 to 1945 and the most
recent from 1951 to 1956, both of the last two epidemics being substantially larger than
the preceding one. (See diagram below.)
NOTIFICATIONS OF DYSENTERY—LONDON A.C. 1930-1956
Practically all the notifications represented infection with the mild Sonne type of
dysentery and they showed the usual seasonal incidence with the peak of the epidemic
occurring at the end of March. The secondary autumn peak that formerly characterised
this disease was again absent in 1956; the disappearance of this peak has been accompanied
by a notable decrease in food-borne epidemics of dysentery.
The year saw a marked increase in the proportion of notifications falling in the
5-14 year age group. There were more cases at this age than in younger children.
A disease that was formerly largely a problem in nurseries now presents problems in
the schools and attention has been given to possible methods of preventing spread of
the disease in schools.
The disease spreads quickly to other members of the family in the home, the younger
children being most frequently affected. The increased risk to mothers of children is
shown by the fact that whereas at ages under 15 years the sexes are affected about
equally, at older ages women arc affected about twice as frequently as men.
Enteric fever
There was a fall in the number of notifications of enteric fevers from 111 in 1955 to
73 in 1956. There were no considerable outbreaks, the notifications representing for
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