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Prevalence and Control
over Infectious Diseases
From the table of notifications set out on page 53 it will be
seen that 887 cases of infectious disease were notified during the
year, as against 797 in 1946 and 1,006 in 1945. The Infectious
Sickness Rate for the district was thus 11.93, as compared with
10.96 during 1946 and 15.48 in 1945.
The rise in the infectious sickness rate for the year was entirely
due to an increase in measles and pertussis notifications. The rate
for the year is altogether lower than the average for the past five
years.
Diphtheria.—For the second year in succession only two cases
of diphtheria were notified. These occurred in adults, both in the
same family. The absence of diphtheria from among our child
population will be referred to in more detail in the section on immunisation,
but it would appear reasonable to state that, provided the
present level of immunisation is maintained, this disease need hold
no future terrors.
Scarlet Fever.—Scarlet fever notifications rose by 13 during
the year, although the total for 1947 is no more than the average for
the past 10 years. The type of disease met with has been mild,
admission to hospital only being necessary in 51 cases.
I am more than ever convinced that the admission of mild cases
of scarlet fever to hospital is undesirable unless the home conditions
are such that home nursing is not a practicable proposition. It is our
practice to investigate all such requests for admission to hospital, and
to withhold permission for a case to be removed unless we can be satisfied
that removal to hospital is in the best interests of the patient.
Exceptions are made in the case of patients who cannot remain at
home because of family circumstances, or who cannot be isolated
and nursed in a separate room.
It must always be remembered, of course, that the present mild
variety of scarlet fever may only represent a passing phase and that
the severe type, common before the war, may at any time return.
Should such be the case, the disease known as scarlet fever—the
term is largely a misnomer and possesses little real significance
nowadays—may have to be regarded in a different light. Until that
time arrives, however, we should continue to regard scarlet fever as
a clinical syndrome which can be produced by a substantial variety
of streptoccoci and which is best treated outside hospital, if complications
and relapses are to be avoided.
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