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6
Cerebro-spinal Fever.
Only two cases of Cerebro-spinal fever were notified
as occurring among the civilian population of the District
One which occurred in March was treated in a County Hospital, and
the other, a male nurse who contracted the disease in December, was
treated at the Isolation Hospital. Both recovered.
Measles
This disease, which with Whooping Cough again became
notifiable in 1940, was much less prevalent than in the preceding
year, when 275 cases were notified. Only 52 cases were reported
in 1944 and of these 33 occurred in December. Measles usually
occurs in epidemic form in alternate years and the increased
number of cases at the end of the year presaged the widespread
outbreak since experienced,, No deaths occurred from this disease.
Reference is made in the Section on Infectious Disease
Prevention to the use of placental serum, which was first encouraged
by the Council during 1943/44-but not used until 1945.
Whooping Cough.
The number of notifications of cases of Whooping Cough
during the year was almost the same as in 1943, i.e. 51 compared
with 55. (In the two previous years this number was 36 and 136.)
Unfortunately 2 deaths occurred from this disease in very young babies.
As in the case of Measles, it is only a proportion of
the cases which are seen by a Doctor and not all of these which
are notified. This tendency, which is partly due to the fact
that these two diseases have only been notifiable during the two
war periods and which partly reflects the more casual, though
unjustified attitude to them, as compared with other notifiable
diseases, is unfortunate insofar as it limits the possibility of
preventive measures referred to later in this report.
THE CONTROL OF INFECTIOUS DISEASE
The usual measures to restrict outbreaks and spread of
infectious disease were employed during 1944, including the
following:
1. Diphtheria Immunisation.
This was continually encouraged during the year but in
the second half of the year enemy air attack and evacuation had
a very disturbing effect. It was partly to meet the difficulty
of assembling mothers and children during the period of the
Flying Bomb attacks that use was first made of Alum Precipitated
Toxoid (A.P.T.) at the clinics. Previously Toxoid Anti-Floccules
(T.A.F.) had been used, but this necessitated three visits at
intervals of approximately a fortnight, whereas A.P.T. only
requires 2 visits about 4 weeks apart. Unfortunately A.P.T. is
more likely to cause local irritation in the child, but on the
other hand it probably has a more rapid and profound influence on
the development of immunity. Furthermore the child only
experiences the more or less distrubing effect of injections on
two occasions instead of three.
In time it is hoped that an efficient product will be
obtainable which will only necessitate one injection, but meanwhile
it is proposed to continue with the use of A.P.T. as being, on the
whole, the most desirable material for the immunisation of young
children.
During 1944 it has also appeared desirable to
introduce the routine use of an enhancing or "boosting" dose as
the child enters school or shortly afterwards, according to the
age at the time of the original course, gather than following in
all cases the previous practice of routine Schick testing, coupled
with additional doses when indicated. Where circumstances