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vague symptoms of a short febrile attack and the slight muscle
weakness in a fretful child who has remained in bed for several
days is difficult to assess. Lumbar puncture seems scarcely justified
to confirm the diagnosis, so vague and fleeting are the clinical
symptoms and signs. One wonders how many of these cases are
completely missed and how many could be more confidently
diagnosed by improved methods of investigation and isolation of
the virus.
Detailed reports on water supply, milk, food, fruits and
canned food have shown nothing to indicate an infecting agent
among the common items of food and drink.
Early in the outbreak a case occurred following tonsillectomy.
On 31/7/47, Claud H—■—, a Dock Labourer's son was admitted to
King Edward VII Memorial Hospital for tonsillectomy and he was
discharged on 3/8/47, following operation. On 11th August, he
complained of difficulty in breathing and' aching legs and was
re-admitted to hospital, 14/8/48, where he died 8 hours later,
from total respiratory and pharyngeal paralysis. This child was
in the last group of children admitted for tonsillectomy at the
King Edward Memorial Hospital before operations on the nose and
throat were suspended on the advice of the Medical Officer of Health.
Preventive Measures.
Early in August it was considered advisable to open a separate
poliomyelitis block at the Clayponds Isolation Hospital for the
reception of cases notified, doubtful cases being first received into
the Cubicle Isolation Block until the diagnosis was established,
only one case was treated at home.
The home circumstances were fully investigated in each case,
close contacts being advised to report to their doctor should they
be unwell. Two adult contacts employed in factory canteens
changed their work temporarily on the advice of the Medical
Officer of Health. Children who were home contacts were excluded
from school for three weeks. On the occurrence of the disease in
a child attending school the classrooms were inspected to ensure
satisfactory spacing of desks and adequate ventilation. School
canteen staffs and teachers were interviewed regarding recent
illness and sickness in their families. With the co-operation of
the Head Master or Headmistress, a short notice was usually
drafted for the parents of other children in the class, advising
them of the occurrence of a case of poliomyelitis in the class and
the necessity of reporting the illness to their own doctor. The
heads of schools were advised to restrict competitive games to
avoid undue fatigue in children and adolescents. School athletic
meetings and inter-school cricket and football were suspended
until the end of the year,