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38
SECTION G.
INFECTIOUS DISEASES.
The control of infectious diseases necessitates prompt exchange
of information between the authorities concerned, and it is a matter
for gratitude that during the course of the year the liaison between
the Medical Officer of Health and the Hospitals has been built up
and strengthened. By virtue of arrangements made during the course
of the year, the Hospitals keep me informed of any case of infectious
or suspected infectious disease which may occur in institutions under
their control. For our part, we keep the Hospital authorities, doctors,
schools, etc., apprised of all important developments on the infectious
disease front, thereby enabling them to be on the look-out for the
particular infectious diseases which may be rampant at any particular
time. These arrangements would be especially valuable should an
outbreak of a serious infectious disease, for example, smallpox or
enteric fever, occur.
Anterior Poliomyelitis.
In view of the large and widespread epimedic of infantile
paralysis which occurred in the country in the latter part of the year,
we were indeed fortunate to have only 27 cases, of which 13 were
paralytic. Last year's outbreak was distinctive in that many widely
separated districts had a large number of cases leaving extensive
intervening areas relatively unaffected. Critical analysis of this
peculiar distribution would rather lead to the conclusion that, spread
out over the country, there are, at certain times of the year, quite
virulent foci of infection. If we take as an example two neighbouring
towns A and B of similar type and of more or less equal population
and find that in A there are a large number of cases, while in B only
two cases occur, the reasonable inference appears to be that a large
number of people in town A have come into contact with the focus
of infection in that town, whereas in town B only those who visited A
have exposed themselves to the risk of infection. This theory would
do a lot to explain the fact that case to case infection appears to be
very rare, for example, the unusualness of more than one case in a
household and the fact that hospital staffs are not particularly prone
to the disease.
Unfortunately we are still floundering in the dark as to possible foci
of infection and, although many ingenious theories have been advanced,
I still adhere, in the present state of our knowledge, to the view that
human carriers are the most likely sources of infection. Before
leaving the subject, a word should be added about immunity. At present
we have no test to determine whether or not an individual is
susceptible to infantile paralysis. It may well be that the majority
of people have a natural immunity to the disease, which could explain