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35
Anterior Poliomyelitis.
We had during the year some 9 cases as against 5 in the previous
year.
Case Details.
Site of Paralysis. Of the 9, 8 showed some degree of paralysis,
the sites involved being lower limbs 4, upper limbs 2, lower and upper
limbs 1, other sites 1.
Ages. The youngest ease was 18 months; 5 were between 5 and
10 years; 2 were between 10 and 15 years and 1 adult was affected.
Hospital stay. Of the completed hospital cases the shortest stay
was 22 days and the longest was 229 days—the average stay therefore
being 79 days.
Month of attack. July showed 3 cases. The first occurred in
June and the last in October.
Household contacts at risk. 23 adults were in the affected households
as against 14 children under the age of 15 years.
Supervision of contacts. Periodic visits were made for the usual
supervisory period and no illness was ascertained.
Progress. The most recent information suggests that of the
paralysed cases 4 have recovered without any material disability
remaining and 4 are still attending hospital for physiotherapy but
are making good progress.
Remarks.
It is disconcerting to note that the last year's ratio in which the
non-paralytic exceeded the paralytic has now been completely reversed
and although no death occurred and the paralysis was not of a central
character, it is to be hoped that if this disease continues to trouble
us—as there seems every indication it will—the paralytic forms will
again tend to be in the minority and to be of minor degree.
It is a truism of course to say that Poliomyelitis is a very complex
subject with which to attempt to deal and certainly to control. It is
interesting to note that one of the cases followed at a short interval
after an undiagnosed febrile illness in another member of the household
and it may well be that if a completely detailed and accurate record
could be ascertained of the movements of cases and contacts over a
material period it would be possible often to establish evidence of a
case to case link. It is, however, clearly very difficult to do this and
in fact is practically in many cases impossible. In general public
health work in any district there is not in practice such a thing as a
'closed community' and hence even in a relatively small outbreak
such as ours in 1953 there is evidence of persons coming into the district
on holiday with relatives and others leaving the district. Whilst a
contact line must be drawn somewhere it is also a fact that playmates
or persons visiting a house may be as close or even closer contacts of
the case than other persons resident in the house. It is thus possible
and—although it does not come within scope of this report—I think
there is some basis for a supposition that a case in this district may