View report page

40
SECTION F.
PREVALENCE OF AND CONTROL OVER INFECTIOUS
AND OTHER NOTIFIABLE DISEASES.
Certain diseases such as Scarlet Fever are so mild that a firm
notification may only be possible at a relatively late stage when the
full implications of the condition become apparent. Other conditions
such as Erysipelas whilst notifiable do not in my view at the present
time require to be treated with this sense of importance. I think
that the policy of notification should be rendered more flexible than
it at present is so that diseases once made notifiable could be taken
from the list in the light of experience and if necessary after a period
of time and further experience restored. This might lead to some
slight confusion but I do not think it could make the position
appreciably worse than it is. It would at any rate have the benefit
of realism.
The role of the Public Health Department in Infectious Disease
at the present time is concerned substantially with the prevention of
spread and the control of contacts. This in turn is clearly indebted
directly so far as concerns any preventive success to the phase of the
disease at which notification is made—hence a notification coming to
light weeks or even days after the onset of the disease tends largely
to be valueless.
I think that our function in this connection is one which ought
to receive publicity particularly in the education of the undergraduate
and in the many post-graduate courses open to general
practitioners and to hospital officers. Improved enviromental hygiene
may have lessened somewhat the burden borne by a Medical Officer
of Health and his Department with regard to the control of
infectious disease but the importance of the work of his Department
is in danger of becoming more overlooked than the circumstances
of the case can reasonably be held to warrant.
Scarlet Fever.
93 cases occurred during the year (as compared with 225 in
1954) and six of the cases were admitted to hospital for various
reasons which rendered home isolation inadvisable or impossible.
The type of disease appears to be mild and its complications appear
to be few. This whilst eminently satisfactory clinically brings in its
trail more difficulty in achieving control both of the individual and of
the spread of infection since the milder the clinical type of disease
the less seriously is it taken by everyone and the less importance
is devoted to regarding it as being infectious at all. Our attention
has been directed largely to supervising contacts in which their
position relates to the community at large, e.g. employees in food
trades were of real importance. At the present time I think it is
debatable whether Scarlet Fever is of sufficient importance as to be
continued as a notifiable disease.