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of notification reduces the value of visitation, which, as a
result, has been limited to cases occurring in very young
children. It was for this reason that the Health Visitors
only visited 111 children during 1943.
WHOOPING COUGH.
Similarly; although 55 notifications of Whooping Cough
were received under the sane Order, compared with 36 and 156 in
the two previous years, this number is undoubtedly much less than
the number of cases; which actually occurred; 56 cases were visited
by the Health Visitors, but more must have occurred of which the
Department was unaware.
PNEUMONIA.
Only acute primary and acute influenzal pneumonia are
notifiable and 27 such cases were notified during the year
compared with 58 and 32 in the two preceding years and 52 in
1939.
THE CONTROL OF INFECTIOUS DISEASE.
The usual measures to restrict outbreaks and spread of
infectious disease were again employed during 1943. In addition
the following more recently introduced methods justify comment.
1. DIPHTHERIA IMMUNISATION.
The national policy of encouraging the immunisation of all
children against diphtheria was continued during the year and
locally the degree of success achieved can be deduced from the
fact that at the end of the year it was estimated that 45% of
the children under 5 years of ag and 85% of the children of
5 years or over but under 15 years had been immunised. It is
becoming more and more a recognised procedure to have children so
treated after their first birthday but the custom is not so
deeply rooted yet that steady propaganda can be discarded.
Similarly parents need encouragement to have their children
tested and/or given a "boosting" dose before admission to school.
At the present time the concensus of medical opinion appears t<
favour an initial course at the first birthday with a single
boosting dose at 4½ years of age, possibly repeated at 10 years
of age. Where practicable the use of the Schick test may assist
in the discovery of the small minority requiring special attention.
It is also possible that it may prove desirable for antenatal
mothers to be actively immunised in order to convey increased
immunity to their children for their protection curing the first
year of life.
The following are the local figures showing the number of
children immunised at the local clinics during 1943. These do
not include the appreciable number treated privately, of whom it
has proved impracticable to obtain reliable data.
CLINICS.
Number of sessions held during 1943 141
Number of children who commenced treatment 666
Number of children who completed treatment619
Number of Schick tests made 573
Total number of attendances 3579
SCHOOLS.
Number of visits made 52
Total number receiving complete course 165
Number of Schick tests made 440