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relatively small number of cases of measles which occurred in 1956.
Even so, whooping cough and measles were the commonest diseases
to be notified, with dysentery close behind. The number of cases
of dysentery and scarlet fever decreased slightly but those of
pneumonia increased correspondingly.
In comparison with earlier years it is better to omit reference
to measles, whooping cough, and food poisoning, which were not
notifiable from 1920-1939, and also the mental hospital cases of
dysentery. The remaining acute infectious diseases then shown an
incidence of 2.4 per 1,000 population which is just above the
average of 2.2 since the war, but well below the averages of 6.7
(1915-24), 3.9 (1925-34) and 3.3 (1935-38).
SMALLPOX.
No case of this disease has occurred in this District since
1932, but in most years contacts with cases overseas and suspected
cases have to be visited and kept under observation. In 1956.
however, only one suspected case was visited for the purpose of
diagnosis. The seriousness of the outbreak in Brighton in 1951
illustrated how important such preventive measures and vaccination
still are.
DIPHTHERIA.
For the tenth year in succession no case of this disease has
been notified in the District, but cases and deaths are still occurring
in some parts of the Country. It is well to remember that from
1915-24 the average number of cases locally was 40 each year
and from then until the end of the war the average was about 18,
with 1 or 2 deaths resulting in most years.
SCARLET FEVER.
In 1860-70 this disease caused 70 deaths in every 100,000
population. In 1911-13 this number was decreased to 5, but it was
still one of the more dangerous diseases. Locally until about 1932
it accounted for one death every other year, but during the last 20
years or so it has been very much milder, though liable to cause
permanent damage from its complications. As it became known
that the germ which caused the disease was much more wide spread
than was originally thought, the attitude to preventive measures
altered. (It so happened that treatment also became much more
effective during the same period).
The present attitude is that prevention by the isolation of
cases is no longer likely to be effective and contacts of cases can
continue to attend school or work providing they are well. On
the other hand, as the virulence of the organism may increase again
and there are still special circumstances in which it is very undesirable
for the organism to be allowed to spread indiscriminately,
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