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Vaccination against Smallpox
The following table records the number of persons under the age of 16, known to have been vaccinated or
re-vaccinated during the year by general practitioners and clinic medical officers.
NOTE: Following the receipt of Circular CMO 12/71 from the Department of Health & Social Security, dated 12
July 1971, smallpox vaccination in clinics ceased.
Under
1 year
1 year
2 - 4 years
5 - 15 years
Total
Number of primary vaccinations 15 295 1,286 134 1,730
Number of re-vaccinations — 2 108 1,166 1,276
Infectious Diseases
W.T. Orton, Deputy Medical Officer of Health
A significant and increasing proportion of intestinal infection orginates abroad, tourists being particularly
vulnerable. We must, therefore, hope that some Southern European countries will, in the future, undertake
adequate practical means of prevention of salmonellosis, especially typhoid and paratyphoid fevers.
Measles
Measles vaccination has so distorted the normal biennial pattern of measles that it is no longer possible to be
certain of a definite seasonal variation. However, there was evidence of a rise during the winter, reaching a weekly
maximum of 75 at the end of February which fell away to below 10 in May, where it remained for the rest of the
year. There was a total of 882 notifications, an unnecessarily high figure resulting from the failure of many parents
to have their children vaccinated against measles.
Meningococcal Meningitis
A young child attending a private day nursery developed a fulminating infection which rapidly proved fatal. In
view of the urgency of the situation, a local general practitioner prescribed one of the sulpha drugs for all those
who had been in close contact, in case any of them were incubating the disease. All the family doctors involved
were informed of this action and concurred with it. No other cases developed subsequently.
Enteric Fever
Infections of this kind, usually taking place abroad, have been more common this year.
The one case of paratyphoid was evidently infected on holiday in Spain. On contacting the travel agency
concerned it was found that a member of their staff had had gastro-enteritis which could have had the same origin
and have infected the patient. The Department of Health was informed but it is not known whether any action
was taken by the Spanish authorities.
Two cases of typhoid occurred after visits to India. Another took place in a child who had been to Turkey. His
illness presented as a fever of unknown origin, and all investigations proved negative. Only after he was discharged
from hospital cured was a report received which gave clear serological proof that he had had typhoid.
There were considerable language difficulties in investigating an infection in a young man who became seriously
ill after returning from Italy. It eventually became evident that either the disease had had an unusually long
incubation period or he had been infected after return. Enquiries were made in various local cafes he had visited
and specimens obtained, but all were negative. It would appear that the former explanation is probably the
correct one, especially since the organism was of a type usually found in Italy.
An exceptionally difficult problem, which has not been completely solved at the time of writing, began when a
family containing a known typhoid carrier moved in to Haringey from a neighbouring borough. Normally
typhoid carriers are not difficult to deal with from a public health point of view as long as they are not food
handlers or work very closely with young children, and most accept our advice on personal hygiene and are not a
danger to the public. We were, however, anxious about this lady, who herself had been infected abroad, and had
subsequently passed on the disease to two relatives and a neighbour's child. She was visited at frequent intervals,
warned about the risk of the spread of infection, advised on hygiene and, as she was known to have an unhealthy
gall bladder, she was advised about an operation which could probably improve her health and might also render
her free from infection. Later on, one of her own children took ill with the disease and she has now decided to
have the operation.
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