London's Pulse: Medical Officer of Health reports 1848-1972

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Hornchurch 1958

[Report of the Medical Officer of Health for Hornchurch]

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41
therapeutic and preventive medicine. It is essential that if diseases are to
be notifiable and hence to receive attention from the outset they must be
viewed primarily in the light of their present-day potentialities and not
in that of history.
Probably the greatest present-day menace is Influenza of which only
its complication—Pneumonia—is notifiable and in truth it would be idle
to notify specifically the thousands of cases of all the diverse patterns
which arise in every epidemic. Although also the clinical pattern is
definable broadly there is still a similarity in mild cases to the common
cold and the like which would prejudice the interpretation of notifications.
Scarlet Fever is not in my opinion a priority for notification for
reasons generally outlined elsewhere.
Measles and Whooping Cough notifications are largely a waste of
everyone's time since it is impracticable to have each case visited and the
complications have largely lost their terror with progress in treatment.
Why Erysipelas remains notifiable is not clear.
When the rationale for notification in any disease is not patent then
the process of notification becomes prone to disregard and subsequent
action becomes a source of frustration and practically ineffective. That
reflects the present position.
We would be better off with a few diseases notifiable on their current
record and with readily available means of augmenting or diminishing
their numbers than with a relative multiplicity whose contribution is
more notable for their clerical than for their hygienic repercussions. In
this latter connection the transfer under Schedule 10 of the National
Health Service Act of a copy notification to the County Medical Officer
within 48 hours may serve some useful purpose but if so—apart from
serving as a basis for our recovering the notification fee—it is not known
to me.
Meningitis.
Five cases were notified during year. Here again therapeutic medicine
has vastly changed the position for the better.
Scarlet Fever.
Scarlet Fever continues to be a mild disease often coming to light
at a late stage and hence becoming practically impossible of rigid control.
Fortunately its danger potential has decreased with the years notably
because of its susceptibility to antibiotic therapy and of the lessened
likelihood of communal spread through, for example, milk (since almost
all milk in Hornchurch is heat treated).
It is always possible that the type of this illness may change but
until some trend in this connection is evident it is not likely to continue
to be regarded very seriously by either medical or lay opinion.
129 cases were notified during the year, of which 87 were in school
children. The distribution throughout the district was general . 7 households
produced more than one case—3 cases were removed to hospital.