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INFECTIOUS DISEASES
Notifications of infectious diseases for the years 1955-64 are shown in table V.5,
page 21, those for certain such diseases by age and sex for the 13 four-weekly periods of the
year 1964 are given in table V.6, page 22, and deaths from infectious diseases are included
in table V.3, page 19.
Diarrhoea and enteritis—There were 27 deaths under the age of two years from diarrhoea
and enteritis, this being a lower figure than that reported in 1963. A high proportion of
the deaths from this condition were associated with concurrent infections of the respiratory
tract and took place in the first quarter of the year.
Diphtheria—During the year there were four notifications of diphtheria, all in Southwark.
Diphtheria has in recent years ceased to be an endemic infection in London. Whenever the
disease is found an energetic search is made for other infected persons in the neighbourhood
and this is continued until the infection has been eliminated from the district. Vigilance and
general immunisation continue to be necessary. The circumstances of recent outbreaks
suggest that they may have resulted from infection imported from abroad.
Dysentery—There were 2,262 notifications of dysentery compared with 4,917 in 1963.
The highest incidence of the disease was in the months of February and March and the
lowest in the autumn, this being the usual seasonal pattern. Once again the highest attack
rate was in pre-school children. The overwhelming majority of notified cases are of mild
Sonne dysentery, which has a low fatality rate. One death from dysentery was registered.
Enteric fever—No local outbreaks of typhoid or para-typhoid fever were reported,
although a number of single sporadic cases occurred. A high proportion of cases reported
had been infected on holiday abroad.
Influenza—The number of deaths from influenza (28) was the lowest for many years.
Leptospirosis—For the eighth successive year there was no case of leptospirosis reported
among the Council's sewer workers.
Measles—1964 was an inter-epidemic year, the low incidence encountered in the early
months building up in the latter part of the year towards the epidemic peak experienced
early in 1965. The disease continues to be mild in the majority of cases. During the autumn
injections of measles vaccine were given to over 5,000 children in London as part of a
controlled trial organised by the Medical Research Council. The results of this trial are
awaited.
Ophthalmia neonatorum—The number of notifications rose from 96 in 1963 to 112 in
1964 and the rate per 1,000 registered live births increased accordingly from 1.31 to 1.51.
The number of cases among children born to London residents was 80; in 70 cases vision
was unimpaired and there was no information about the remaining ten who had moved
from the area.
Poliomyelitis—Only two cases of poliomyelitis were notified during 1964. That only
two cases occurred in London in spite of the fact that many thousands of children remain
unvaccinated indicates the virtual absence of disease-producing virus from the community.
This must be attributed largely to the widespread use since 1962 of the Sabin vaccine which,
unlike the Salk-type vaccine, has the effect of reducing the number of symptomless carriers
in the population. Thus poliomyelitis, like diphtheria, has now reached the stage when the
low level of incidence depends as much on the absence of infection from the community
as it does on the high level of immunisation. The continuance of this favourable condition
will require vigorous preventive action in the contacts of any case that does occur.
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