View report page

scarlet fever in which the rash is either transient or non-existent.
Recent advances in bacteriology have helped to clarify the situation,
but the time appears overdue for a new approach to this complicated
problem.
Puerperal Pyrexia.—The significance of puerperal pyrexia
notifications has considerably changed since the regulations were
altered in 1939. Now that any condition which can cause a rise in
temperature over a comparatively short period is included in the
generic term "puerperal pyrexia," such transient and non-infective
•conditions as constipation fall within this category. This is not
to say that the notification of such conditions during the puerperium
is not proper; this is far from being the case. We should have a
full and detailed record of all such abnormalities, whether or not they
possess any clearly defined epidemiological significance. By no
other means can we hope to increase our knowledge of a condition,
or group of conditions, concerning which further information is
still urgently required.
Measles.—The fall in measles notifications was due to the fact
that 1946 was a non-epidemic year so far as this disease was concerned.
In spite of this fact, it will be noted that the number of
cases reported made up 51.57 per cent, of the total cases of infectious
disease notified during the year. The explanation is comparatively
simple, the solution much more difficult. Measles is a virus
infection, and is not subject to control by immunisation or
vaccination. Nor is its treatment influenced by the use of sulpha
drugs or penicillin, except in so far as secondary infection may be
concerned. Thus, while such diseases as diphtheria, typhoid fever
and pneumonia have been brought under reasonable control, measles
continues on its way with little let or hindrance. This is unsatisfactory,
especially when the after-effects, not so serious as in past
decades but still demanding our attention, are remembered. The
use of gamma globulin and similar concentrated serum preparations
does, however, hold out hope that the spread of measles may at last
be checked. The Central Public Health Laboratory has been most
helpful in supplying "measles modifiers" to general practitioners,
whilst our Day Nurseries have also had the benefit of this latest
safeguard. There can be little doubt that the scientific use of measles
modifiers would go far towards reducing the unpleasantness, as well
as the dangers of measles, and it is in this direction that we must
look for future progress. So long as measles notifications remain at
their present high level, preventive medicine cannot claim undisputed
victory. At least one major problem remains to be solved,
a problem which, with the decline in other infectious diseases,
calls for solution more than ever before.
46