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4
Another fact that disturbs me is the continued decrease in
the number of infants who receive the protection of vaccination
against smallpox. Fortunately, smallpox is not endemic in this
country nowadays, due mainly, I consider, to vaccination, but
during the last few years there have, been several outbreaks of
this disease in the country and Enfield has not escaped its share
of contacts. Although these contacts are offered immediate vaccination
(which may be too late) and kept under surveillance for
a period, the difficulties in controlling an outbreak in a community
with a low state of vaccination are considerable. An outbreak of
smallpox usually results in hurried mass vaccination with its
consequent disorganisation and occasional additional risk to those
not previously vaccinated in infancy.
So long as reliance is placed on surveillance of contacts for
control (and I favour stricter measures), and in view of the rapid
travel by air from infected countries, the risk of smallpox appearing
in the community will ever be present.
During the year, only one case of food poisoning was notified,
but, in addition, a mild outbreak of gastro-intestinal disturbance,
involving a number of people employed in a factory, was brought
to my notice and investigated. An account of this outbreak is
given elsewhere in my report. I am convinced that there must be
many instances of minor gastro-enteritic upsets due to food poisoning
which are not notified owing to the mildness of the attack and
for other reasons.
We must try to impress on the housewife and the food handler
the absolute necessity of cleanliness and attention to personal
hygiene because it is not only the classical food poisoning organisms
that must be kept at bay, but also those ubiquitous organisms
present in and on the human body which, under certain conditions,
can cause outbreaks.
In conclusion, I should like to record my appreciation of the
efforts of the staff of the Health Department during the past year.
William D. Hyde,
Medical Officer of Health.