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2. INFECTIOUS DISEASES
The prevention of spread of infectious disease is achieved by a system of notification
of cases and the subsequent control of cases and contacts.
NOTIFICATIONS
The following diseases are notifiable in the London Borough of Ealing:—
(1) Under the Public Health Act, 1936, medical practitioners are required
to notify smallpox, cholera, diphtheria, membranous croup, erysipelas, scarlet
fever, typhus, typhoid, enteric and relapsing fever.
(2) The Minister of Health has also made regulations under the Public
Health Act whereby also notifiable are plague, acute poliomyelitis, tuberculosis,
puerperal pyrexia, ophthalmia neonatorum, malaria, dysentery, acute primary
pneumonia, acute influenzal pneumonia, anthrax measles, whooping cough, acute
encephalitis and meningococcal infection.
(3) Under a Special Order made by the Council during the year and confirmed
by the Minister of Health, infectious hepatitis is also notifiable.
(4) Food poisoning is notifiable under the provisions of the Food and
Drugs Act, 1955.
(5) Under the Milk and Dairies (General) Regulations, 1959, the occupier
of premises used in the milk trade must notify the Medical Officer of Health if
staff are suffering from, or have been in contact with, any of the diseases
enumerated above. In addition to these diseases the occupier of such premises
has the same obligations in respect of gastro-enteritis.
CONTROL
It might be thought that with the lessening in incidence and severity of many
infectious diseases that there would be a corresponding decrease in importance of
this aspect of the work of a Health Department. This, however, is not the case.
It is true that many diseases have altered radically over the last 30 years, smallpox
and diphtheria for example being now a rarity, and scarlet fever, whilst still fairly
common, has become a mild disease. Although I consider there is a great need for
some re-thinking on the necessity for control measures for certain diseases, in general
constant attention must still be paid to measures of control if a satisfactory position
is to be maintained.
The principle of control of a serious infectious disease is that as soon as a notification
is received a detailed picture of the patient's movements, immediately prior to
and during his illness, must be built up in the shortest possible time. The purpose
of this is to compile a list of contacts so that they may be traced and kept under
surveillance until it is certain that they have not been infected. It may be necessary
to restrict their movements during this time if they are in any way a potential cause
of spread. This measure is always of importance, but where a contact is employed
in the food trade or with young children it is doubly so, since these are circumstances
which possess the potential for extensive spread.
In the case of intestinal diseases, contacts may become carriers and although
symptomless themselves carry and can pass on the infecting organisms. Laboratory
testing is required to determine when they are no longer a danger, and surveillance
must continue until this is so.
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