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41
When an epidemic occurs in the winter months the difficulties
of treatment appear to be greater. There is no specific treatment
tor the disease. The results obtained from the use of the Bordetbengon
vaccine have been unsatisfactory. The Bordet-Gengon
bacillus is characterised by a signal absence of toxin formation
in culture, and a remarkably low virulence towards laboratory
animals. Cultures of the bacillus in strength of billions of bacteria
per c.cm. have been injected into small guinea-pigs without producing
untoward results. Similarly, in the use of vaccine for
prophylaxis and curative action in cases of whooping cough,
children have shown a remarkable tolerance for quite enormous
doses of the bacillus. In view of the immunity which an attack
of whooping cough confers upon a child, it is reasonable to doubt
if the Bordet-Gengon bacillus is the real cause of whooping cough.
It is well known that second attacks are very rare, and artificial
immunisation should not therefore be difficult.
Measles.
There were 12 deaths from Measles in 1932. In the early
part of the year there was an extensive outbreak of Measles, which
comemnced in the southern part of the district but which ultimately
spread through all the wards.
When the schools re-opened after Christmas several cases
of Measles were found to have occurred during the holidays.
Although we are not self contained as we were formerly, and the
first cases which occurred in the district were fairly easily traced,
we still frequently trace the source of the infection of Measles. In
this instance, though, the original case which gave rise to the present
outbreak was not traced. It had been known that Measles
became prevalent in London towards the end of 1931.
The administrative County of London is such a huge area
that deaths from Measles appear in every weekly return of deaths.
In this respect it differs from all other towns in England and Wales.
In other places Measles is an explosive outbreak and then "the town
is entirely free of the disease for a year or two and no deaths from
Measles appear in their returns.
In the autumn, London was almost entirely free from the
disease, only one death being usually recorded from the disease,
and on three occasions two deaths occurred in one week.
In the week ended November 14th, 6 deaths were recorded,
but the number was only 2 in each of the weeks ended November
the 21st and 28th. In December the number of deaths steadily
increased, and in the week ended January 16th, the number was 22.