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1928
23
of encephalitis Iethargica was notified and this was the only
notified case of that disease in 1928, and there was no notification
of infantile paralysis.
The following extract from the "Medical Officer" which
translated an article in a foreign journal places the position
probably in its proper light.
"Post-vaccinal encephalitis continues to occur in Holland.
In the first six months of 1928 its incidence was the same as in
1927, one case per 2800 vaccinations. During five weeks, lymph
was used which had been obtained from countries where postvaccinal
encephalitis is unknown, but in spite of the small numbers
of vaccinations performed with this lvmph, one encephalitis case
occurred after its use. The disease is definitely not encephalitis
Iethargica, the histological changes are quite different from
those of that disease, but are identical with those occurring in
small-pox, chicken-pox and measles. The disease occurs only
in those countries where primary vaccinations are performed
during the school age or where primary vaccination in infancy
is not compulsory. There is no modification of the local reaction
in cases which develop encephalitis."
The incidence of one case per 2800 vaccinations is far
higher than the records of this country suggest. Dr. Turnbull
suggests that in this country there are about one case to 17,000
vaccinations.
The occurrence of these cases have been used as an
argument against vaccination, but it is really one of the
strongest arguments in favour of vaccination in infancy. It is
a disease of children rather than of infants or adults, though no
age is exempt. The disease is very rare after primary vaccination
in infancy and after re-vaccination at any age; nearly all the
cases have followed primary vaccination during school age.
There is no definite record of the occurrence of post-vaccinal
encephalitis after a previous vaccination which "took."
There is no use in trying to avoid a difficulty which exists.
Small-pox is prevalent in London and it is more than probable
that there will be a recrudescence of it in the coming winter.
We have amongst us a large number of children who are unvaccinated,
and the occurrence of encephalitis will hamper us in
the prevention of Small-pox.
Scarlet Fever. INFECTIOUS DISEASES.
243 cases of Scarlet Fever were notified, but there was
no death from the disease.
The control of Scarlet Fever has become very difficult.
The disease is frequently so mild, that the proportion of