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As has been noted in the last 14 years, the disease is almost
entirely confined to school children and a smaller number of
younger children. The proportion who were admitted to hospital,
which until 1946 was at least three-quarters, decreased steadily
until in 1953-54 it was only one quarter. In 1956 it rose to about
40%, but in 1957 only 15% were admitted, without any obvious
increase in secondary cases resulting. The admission of some cases
may be justified in order that they shall receive better treatment,
but not as a preventive measure.
ERYSIPELAS.
This disease, which is also due to a streptococcus has never
been a major problem and since 1942 only a very few cases have
been notified in any year.
PUERPERAL PYREXIA.
This complication of pregnancy, which was also usually due
to a streptococcal infection and frequently very serious, has, fortunately,
become of insignificant importance, thanks to aseptic
technique and the effectiveness of newer types of drug treatment.
In the four mild cases notified in 1957 the rises in temperature
within 14 days of the confinement were mostly due to a mild
infection which responded rapidly to penicillin-like drugs.
PNEUMONIA.
Only cases of influenzal and primary pneumonia are notifiable,
i.e. those due to a specific infection by the influenzal virus or
by pneumococci, and in 1957 there were 26 cases notified, which
is only one above the average for the last 12 years. The cases
occurred mainly in the early months of the year with a secondary
increase in October. As usual the majority were in the Purley
area, but only in 2 sets of twins did the cases appear to have any
connection with each other. So far as is known, 8 were admitted
to hospital and not a single death resulted from this infection.
ENTERIC FEVER.
During the year no case of typhoid or para-typhoid fever was
notified whereas since the war about 3 cases have occurred on the
average each year.
The source of para-typhoid infection is usually some food
stuff, while typhoid is more often traceable to water. As it is
not uncommon for these intestinal diseases to occur in persons
returning to this Country from the Continent, the desirability of
prior inoculation against typhoid and para-typhoid should be
considered, especially if going to countries in which the hygienic
standards are inferior to ours.
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