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DIPHTHERIA.
Only five cases were notified during the year. In only one year
1936) since the notification of infectious diseases was instituted has
here been as small a number of cases.
One of the cases proved fatal—a little girl aged 3 years ; she
lad not received any protective inoculations. Two of the other
cases had received protective inoculations : the attacks developed
even years and three and a half years after the completion of the
courses of injections: in both cases tests carried out six months
after the injections were satisfactory.
SCARLET FEVER.
The incidence was low all over the district in 1945. As indicated
in previous reports, Scarlet Fever incidence in Beckenham has
had a fairly regular rhythm—years of high incidence being separated
by periods of low incidence. During recent years the rhythm has
become less regular, partly no doubt because there have been more
extensive movements of population.
The infection was mild in all cases.
TYPHOID FEVER.
One case was notified during the year and it ended fatally,
Investigation failed to reveal the source of the infection. No other
cases occurred at the time in Beckenham or in neighbouring areas.
Such sporadic cases are usually caused by the chance surface contamination
of food by undetected carriers of the disease.
DYSENTERY.
(a) Amoebic. The one case notified was a recrudescence of an
infection contracted abroad a good many years ago.
b) Bacillary. (Type Sonn6). Only twelve cases were notified but
there is no doubt that many more occurred during the year. There
is reason to believe that this type of infection has been widely
prevalent all over the country for a number of years. The large
majority of the cases is extremely mild—a gastro-intestinal
upset which clears up in about two or three days—and it is only
in a few cases that the services of a doctor are sought. It is only
the occasional case which presents the classical symptoms of the
disease.
It is this mildness which assists the spread of the infection.
Even a mild unrecognised case will go on harbouring the infecting
bacilli in the bowel for a few weeks and unless scrupulous personal
cleanliness is practised all such cases are ready sources of infection
for those who are in close personal contact with them.
In June there was an extensive outbreak of this disease in a
Secondary School in the Borough. Only one case was actually
notified—for the reasons advanced above—but from reports received
from the school authorities in the course of the investigations
it was clear that there were at least 70 or 80 cases. Investigations
soon revealed the source of the infection in a worker in the school
canteen. A week before the outbreak occurred this worker was
absent with an attack of gastro-enteritis : the source of the infection
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