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39
why only one person in a household is usually affected, but if this is
so, the increased number of cases in the community of recent years
can only be explained by the fact that there are more foci of infection
now than there were formerly. This might well be the case, with the
increased inter-continental travel of modern days, by means of which
healthy carriers could import the disease into this country from other
countries where it is endemic.
From the above remarks, it will be clear that, although the
problem of anterior poliomyelitis is as yet unsolved, there are lines of
approach which, it is hoped, will bring forth fruit in the not too distant
future.
Smallpox.
This disease is no longer endemic in the British Isles, but owing
to the modern speed of travel there is always a risk of its being
imported into this country. It is perfectly possible for a person to be
a contact of smallpox, for example, in India, to fly to this country and
to develop the first signs of illness after being here for several days.
If such a sequence of events happened and the patient has been
in addition partially immune to smallpox, he might well be insufficiently
ill to consult a doctor. In such circumstances, the disease could
be spread to a large number of persons before its presence had been
suspected, particularly if the population as a whole were not immune.
In view of this it will be clear that constant vigilance is necessary on
the part of all concerned, if the importation of smallpox on a big scale
is to be avoided ; every day's delay in the control of movement of a
case increases the danger of an epidemic. As the Council are aware,
there were two or three instances of smallpox being brought into this
country during the past year, but they must all be considered to have
been very well controlled.
In view of this ever-present potential risk, it is the practice of the
department to urge the necessity for frequent vaccination of all those
members of the staff who, through the nature of their work, would
be especially exposed to the risk of contracting smallpox, should an
outbreak occur in this district. Owing to the difficulty of differentiating
smallpox from chickenpox and other diseases, any weakening
of the link between the Medical Officers of Health, General Practitioners
and Hospitals, would increase the risk of the spread of
smallpox. I am happy to say this link is locally a strong one.
All contacts of smallpox cases which occurred in other parts of
the country and who became residents in the district, were kept under
daily surveillance for the necessary period of sixteen days. No cases
developed among these contacts.