View report page

mode of travel was known. Nationals of the country concerned were usually responsible for introducing the
disease to their own countries. Since smallpox is extremely rare among people successfully vaccinated in the
last preceding three years. It is reasonable to conclude that more than half the outbreaks in Europe could have
been prevented if travellers had been adequately vaccinated before going to endemic areas.
Enteric Fever
Both the cases of typhoid which occurred this year originated abroad. We were also involved in the follow-up
of contacts of cases in other boroughs. During one of these the family of the case, including a relative who as a
carrier of the disease was the source of the infection, moved into Haringey. Measures were taken to prevent
further spread.
One paratyphoid case occurred just after the patient had arrived in this country from overseas and certainly had
its origins there. The source of the other infection was in this country and remains unknown.
Measles
The withdrawal of one of the measles vaccines in March, 1969, was a serious interruption of a nationwide
campaign to reduce the infection to the status of a less common infectious disease. Vaccination was largely
suspended for several months until alternative supplies became available. Although an intensive campaign was
undertaken to complete vaccination before the autumn of 1970 and the expected biennial measles epidemic,
the public response was very disappointing, only about a third of what had been expected. Contrary to the
usual experience, measles notifications, which usually are greatest in the wintertime, climbed to a peak of over
60 a week in July then dropped to less than 10 in September. Subsequently the old pattern re-established
itself and 60 had again been passed by Christmas.
There can be no doubt that vaccination gives considerable protection, but what appears to have happened
is that many children who were not vaccinated during the first campaign did not catch the disease because
those who had been vaccinated prevented the easy spread of the disease in the child population. However,
since not enough children received the vaccine, the disease then recrudesced and the unvaccinated ones who
had previously escaped fell victims to it.
Measles will therefore continue to be a common unpleasant and sometimes dangerous disease until the great
majority of parents decide to do something about it.
Whooping Cough
This is a disease with wide variations in annual incidence. Vaccination may not prevent it, but does much to
reduce its frequency and severity. In 1967 there were 131 cases notified, 58 in 1968, while in 1969 there
were only 17. This year there were 108. Such wide swings are hard to account for, but some factors have
been recognised. A few years ago a part of the vaccine had to be modified because a strain of the bacterium
had developed which was not susceptible to it More recently there has been evidence that some viruses may
cause an illness closely resembling whooping cough, and information from general practitioners in Haringey
suggests that a small proportion of the cases notified may have been of this kind.
Psittacosis
A local veterinary surgeon informed us of his suspicions that an Amazon parrot bought from a local pet
shop had died of psittacosis. This virus infection of birds can cause a severe form of pneumonia in humans.
The diagnosis was subsequently confirmed.
The stock of birds in the shop was destroyed and the premises were thoroughly cleaned and disinfected.
It was found that members of the staff of the shop had had a mild respiratory infection a week or so before.
Blood samples were taken. These showed no evidence of recent attacks of psittacosis, but a low blood titre of
antibodies to organisms of the psittacosis group showed that they had been exposed to this kind of infection
not sooner than two months before. This had probably occurred in the course of their work.
63