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The disease is infectious right from the onset of the illness,
some days before any actual signs of paralysis are present, and in
many cases the initial symptoms resemble very closely those of
other acute and sometimes quite mild illnesses. When warned of
the presence of the disease in the community, it is possible by careful
examination to arrive at a provisional diagnosis.
There were two limited outbreaks of the disease in the Borough
during the year; an outbreak in the Elmers End and Eden Park
areas during the end of July and the beginning of August; and a
subsequent outbreak in the Coney Hall district of West Wickham in
October and early November. An interval of several months
occurred between the two outbreaks, and it is not possible to establish
any definite connection.
The first outbreak occurred towards the end of July, and the
first notification was received at the beginning of August. In this
outbreak four cases were notified, three being classed as Polioencephalitis
and one as Polio-myelitis. In one case of Polioencephalitis
the diagnosis was a provisional one and it was subsequently
withdrawn. Associated with this outbreak there were
three cases which occurred among Beckenham residents whilst
away on holiday. The total of known cases in this outbreak, therefore,
was six, of which four were severe and two slight; two cases
terminated fatally. The onset of the disease in the severe cases was
very rapid, evidence of paralysis affecting the brain-centres being
present at the end of forty-eight hours.
At this time the schools were closed for the holidays and the
children dispersed ; and although this may have had some effect in
limiting the number of cases, it deprived the Health Department of
one of the most valuable factors in controlling the outbreak. Medical
practitioners were immediately notified of the circumstances, and
received a memorandum indicating the clinical characters of the
cases and the best means of arriving at an early diagnosis in any
suspected cases. Arrangements were made with the London County
Council for the reception and treatment of cases during the acute
infectious stage at one of their special hospitals, there being no
accommodation available for the treatment of this condition at
the Hospital of the West Kent Joint Hospital Board. The weekly
Death Returns were carefully scrutinised and arrangements were
made with the Registrar of Births and Deaths to forward immediately
to the Health Department particulars of deaths occurring
among children. The last notified case occurred cn August 9th.
The second outbreak occurred in October in the Coney Hall area.
In this outbreak the cases were all classed as Polio-myelitis, no case
showing any evidence of paralysis of the brain centres. Cases were
notified on the 16th and 21st October. The practitioners were again
advised, and their assistance in detecting mild cases was very valuable.
Every school child who was at that time absent from school
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