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17
Taking the total of 47 confirmed cases this gives an attack
rate of 0.25 per 1,000 population.
Chart II shows the numbers of confirmed cases in age groups,
the attack rate in age groups being :
0-4 years 0.77 per 1,000
5-14 years 1.06 per 1,000
15 upwards 0.06 per 1,000
The sex incidence of the cases was as follows:—
Males, 30; Females, 17.
Of the total of 47 confirmed cases 6 died, a case mortality
rate of 12.8 per cent. Four of these deaths occurred within 24 hours
of admission to Hospital. Two autopsies were undertaken at the
Clavponds Isolation Hospital. In both cases the findings confirmed
the diagnosis and specimens of brain and spinal cord were pieserved
for isolation of virus.
Incubation Period.
Accurate observation of the incubation period of the disease
is made difficult by the low attack rate and often the indefinite
initial symptoms. In homes where one child in a family has the
disease, the parents are naturally over anxious for the health of
the other children and mild attacks of sore throat or febrile catarrh
tend to be magnified and modified to resemble the first case only
to show on clinical examination where necessary confirmed by
examination of the cerebrospinal fluid, that there are no grounds
for the parents' fears.
Two cases deserve notice in this respect. On 4/8/47, Stanley
T, age 11 years, became ill with sore throat, pyrexia, headache,
backache, with some neck rigidity. He was admitted to the
Clavponds Isolation Hospital, 6/8/47, where he rapidly deteriorated
with increasing coma, pharyngeal and laryngeal paralysis, and
weakness of respiratory muscles, dying in coma, 8/8/47. Diagnosis:
acute anterior poliomyelitis. On 8/8/47, his brother, John T
age 2.7 12th years, living at the same address became unwell with
slight pyrexia, sore throat and stiffness of the neck. He was,
therefore, admitted to hospital 9 8 47, where he was definitely
drowsy and disinclined to sit up. Examination of the cerebrospinal
fluid, 9 8 47, showed Cells 32 lymphocytes per c.m.m.
Protein 55 m.grms/100 c.c. He then rapidly improved—all
symptoms disappeared in 3 days and subsequent examination of
C.S.F., 23 8 47, showed Cells 1 lymphocute per c.m.m. Protein
20 m.grms/1000 c.c. Diagnosis: Abortive Anterior Poliomyelitis.
One wonders whether these two children were infected from a
common source, the younger child having a greater immunity,
or whether Stanley infected John. It is noteworthy that both
children had a sore throat at the commencement of the attack.