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Contacts'. School exclusion for 5 days is the practice commended
by the Education Authority to their Head Teachers not only in Scarlet
Fever but in streptococcal sore throat. Whatever identity may exist
bacteriologically between these two conditions, one is notifiable, the other
is not, and the bacteriology is in any event seldom pursued. Home isolation
is I am sure a more flexible form of control than theoretically might
appear and a specific period such as 5 days is in my view largely academic
in its significance.
Poliomyelitis
A clear drop in the number of cases occurred as compared with 1957.
Paralytic cases:—
In the present year two paralytic cases occurred, one in a woman
aged 47, a resident of Upminster, who suffered from a bulbar type of
infection, the second a boy of 5 from Rainham who had facial involvement.
These two cases compared with a figure of 8 such cases found
in the previous year.
Non-paralytic cases:—
This type was reflected in 8 instances—males of 31, 14 (2), 7, 3 and
1; females aged 30 and 16. Nine such cases were notified in 1957.
How far it is profitable in practice to notify non-paralytic cases is
possibly problematical. In the nature of things probably a large number
of such cases remain undiscovered, the complications are negligible and
a substantial amount of public apprehension is caused. On the other
hand if notification results in minimising the paralytic type of the disease,
then it has valid claims to continuation.
In general the disease still behaves unpredictably and immunisation
appears to offer the best available chance of protection. It cannot of
course be claimed as a complete safeguard and in fact certain of the cases
noted above as having occurred this year are thought to have had two
injections some months before. So long, however, as there is nothing
to be lost and a substantial chance of gain, then clearly immunisation
can be reasonably advocated.
Food Poisoning.
14 notifications represented single cases. In 8 it proved impossible
to isolate the causative organisms. In 5 Salmonella Typhimurium was
isolated and in the other Salmonella Enteritidis.
The local General Practitioners were reminded of the value of full
and prompt notification of food poisoning cases.
International Certificates of Vaccination or Inoculation.
439 certificates were stamped during the year. Although cogent
reasons may exist as to why the practice is not followed, it would
superficially seem distinctly advantageous if a supply of blank forms was
kept at this office as is understood to be the case with Travel Agents etc.
Immunisation and Vaccination Statistics.
I am indebted to Dr. W. T. G. Boul, Area Medical Officer, for the