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very large number of cases of measles which occurred in 1957, this
being much the commonest disease to be notified. While the
number of cases of whooping cough and dysentery decreased considerably
and pneumonia decreased slightly they did not affect
the total number of notifications materially.
When comparing these figures with those of 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 show 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. The seriousness
of the outbreak in Brighton in 1951 illustrated how important
such preventive measures and vaccination still are.
DIPHTHERIA.
For the eleventh 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 had 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,
notification is still required, although there is evidence that this
is being observed with decreasing stringency. The fact that only
47 cases were notified in 1957 is therefore of less significance, and
it cannot be assumed that the disease remained less prevalent.
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