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diseases, with the exception of tuberculosis, are the two
most important infectious diseases experienced at the
present time, leaving out for the moment the unpredictable
incidence of poliomyelitis.
Constant vigilance has to be exercised in regard to
the prevention of smallpox. As a result of the Brighton
epidemic in 1950/51, 22 contacts were traced to this
area and vaccination was carried out by the Health
Department in most cases and intensive supervision
exercised during the danger period. On two other
occasions ships arrived in nearby ports carrying a case of
smallpox and contacts were traced to this area. Vaccination
was carried out wherever necessary and the appropriate
surveillance exercised.
During 1951, 37 cases of paratyphoid fever occurred
in an area covering adjacent London boroughs and
districts in Kent and Sussex. The cause of the outbreak
was judged to be synthetic cream supplied from a food
establishment in a neighbouring district. Some of the
cases occurred in the Borough of Bexley, an extensive
investigation developed and it is likely that the control
measures which were instituted prevented a more widespread
epidemic. In addition to these cases, 7 cases of
food poisoning were notified during the year.
Generally speaking the infectious diseases which
took such a heavy toll of life and health in the past have
diminished in importance but continued vigilance is
needed as some change in the natural history of the
organisms or some lowering of individual resistance in
peace or in war may precipitate a return to former conditions.
Tuberculosis remains the most important of the infectious
diseases which are encountered. It is a tragedy
that this disease which is preventable is not being
prevented. It presents a medico-social problem of great
complexity, a description of which is outside the scope of
this foreword. I would emphasise one aspect, however,
which demands immediate attention, namely, the discharge
from sanatorium to their own homes of open, i.e.
infectious, cases when their continued stay in hospital
can no longer be of benefit to them. These frequently
chronic cases are responsible for a good deal of mischief
and our powers under the Public Health Act to control
this source of infection are inadequate in that such
patients may only be compulsorily removed to hospital
provided suitable accommodation is available for them.
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