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48
admitted that the more we learn of poliomyelitis the less appears
to be our real knowledge of it.
In the past it has had a well marked seasonal prevalence in
the autumn; but the occurrence of cases in June, 1947, gave rise
to uneasiness, inasmuch as it indicated the possibility of a widespread
outbreak as the year advanced. That possibility was confirmed
by the unprecedented and widespread outbreak throughout
the country during the summer and autumn months.
Administrative Measures.
On 26th July there was addressed to all local medical practitioners
a special communication containing information regarding
the special features of the outbreak and the facilities available ;
and on that date steps were taken to postpone local arrangements
for surgical removal of tonsils and adenoids in Leyton children
until such time as the prevalence of poliomyelitis might show signs
of receding. At the same time, in collaboration with your Baths
Superintendent, special precautions were taken to ensure that the
residual chlorine in swimming pools was kept at a constantly high
level, and that all hired bathing suits and towels were adequately
sterilised.
It was not considered to be necessary to take any special
measures with regard to the closure of schools, day nurseries,
cinemas or swimming pools.

Cases Notified during 1947.
On page 50 I submit the relevant information, in tabular
form, regarding the cases of acute poliomyelitis notified during
this year.
Disposal of Cases.
All cases were admitted at once to the fever hospital, where
they were seen regularly by the Council's Consulting Orthopaedic
Surgeon.