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Scarlet Fever.
The incidence was lower than in the previous year, 63 cases being
notified against 107 in 1948. The incidence began to rise again in the
last month of the year.
Cases were generally mild, and the only cases removed to hospital
were those with complications, or those for whom it is not possible to
provide proper isolation or treatment in their own homes. This
practice is a consequence of the new regulations of the Regional
Hospital Board, and I have no reason to object to it. Extensive enquiries
in the past have satisfied me that the incidence of secondary cases is no
greater in the instances of patients who are treated at home, than of
those who are removed to hospital.
Cases occurred in every ward in the Borough, and as usual the
majority of cases were children of school age.
Acute Anterior Poliomyelitis.
Twelve cases of this disease were notified, and nine of them
occurred in the last two months of the year. All of these nine cases were
in the Coney Hall area of West Wickham. It is worth noting that no cases
occurred in this particular part of the Borough during the period of
increased incidence in the year 1947. It was surprising, when the disease
was so prevalent in the rest of the Borough and in surrounding districts
as well as in the country as a whole, to find a populous area entirely
free: naturally, there may have been slight and abortive cases present,
but abortive cases seldom occur in appreciable numbers without the
appearance of cases showing definite signs of paresis. Although the
precise mode of infection is not known, the prevalence or otherwise of
the disease probably follows the general laws of epidemiology. One of
these laws is that the prevalence of any infection in a locality is
intimately connected with the degree of specific immunity among its
residents: and another is that when any particular infection is present,
the number of persons who acquire a degree of active immunity is very
much greater than the number of persons who actually contract the
disease.
This suggests that for some reason or another the Coney Hall area
of West Wickham did escape infection in 1947, with the result that the
general level of immunity there remained lower than in the rest of the
Borough which had suffered rather severely.
It was not possible to establish any direct relation between the
actual cases, though there were several suspected but unconfirmed
abortive cases, which were associated with several of the established
cases.
Overseas Contacts.
Information was received from Ports and Air Ports of the arrival
of 10 persons from areas where Smallpox existed. These cases were
visited daily until it was certain that no infection existed.
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