View report page

5
factors which are not fully understood. This matter is, however
of great significance from the administrative point of
view as well as from the standpoint of the health of the
community. As a result of the provision of pure water
supplies in the middle of the 19th century the enteric and
diarrhoeal diseases generally were largely overcome. Scarlet
fever, which in the 19th century and early part of this
century was one of the main killing diseases, is, nowadays,
a disease of little importance. Smallpox has been largely
overcome by stringent supervision at sea and air ports- and
by the instrument of vaccination, although the possibility of
an epidemic is always present, so that the greatest vigilance
is necessary at all times. The last great epidemic of diphtheria
occurred in the early 1930's and was thought to be
due, largely, to an increase in the virulence of the diphtheria
organism. The introduction of mass immunisation in the
middle of the 1930's, together with great improvements in
environmental and personal health have, practically,
abolished this disease, although small outbreaks of virulent
type do occur from time to time in different areas. The need
to keep the level of immunisation of children at a high
level has often been stressed. It is, of course, possible that
any deterioration in environmental conditions resulting, for
example, from war conditions or other calamity, might
bring all or any of these diseases back in an enhanced form.
Nowadays the main hazard is due to the virus diseases,
of which poliomyelitis is the best known example. There are
reasonable grounds, however, for optimism that the mass
immunisation of the young population may, before long,
in some way alter the relationship between the virus and
the human organism, but it is too early yet to say whether
one can look forward with confidence to the early abolition
of this disease. The antibiotics and chemo-therapeutic drugs
have shorn measles of most of its terrors due, largely, to
preventing the serious complications, such as bronchopneumonia,
which was the main cause of death in years
gone by.
Much discussion is taking place at the present time
as to whether the present system of notification of infectious
diseases which is founded, largely, on experience gained
during the last half-century, does not need to be drastically
overhauled. The notification of measles, which came into
operation in 1940 when environmental conditions were
seriously affected by the war, is regarded by many as being
unnecessary at the present time in view of the fact that