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Puerperal Pyrexia.—The remarks which I made regarding
this disease in my last year's Annual Report hold with equal significance
to-day. The advent of the sulphanilamides and penicillin have
very radically altered the prognosis and treatment of this disease,
and have removed many of its previous terrors. No serious case was
reported during 1947, all the patients recovering without incident.
Acute Anterior Poliomyelitis.—As noted in the introduction
to this Report, seven cases of acute anterior poliomyelitis (infantile
paralysis) were reported during the year. Two of these cases
occurred in July, two in August, one in November, and two in
December. Three of the cases were over fifteen years of age
(eldest 30 years), the ages of the remaining four cases being three,
seven, nine and fifteen years respectively. Two of the cases were
males, and five females. Three of the cases occurred in the South
Ward, one in the Middle Ward, two in the North-East Ward, and
one in the North-West Ward. It will be appreciated that, with
such a small total, very little information of epidemiological
significance can be elicited. There was no evidence of case-to-case
spread, or of the existence of any physical barrier to infection. It
can be assumed, of course, that a number of mild, sporadic and
therefore undetected cases occurred. This number was probably
not high, as general practitioners reported many doubtful cases,
which were all seen and admitted to hospital for observation when
this course appeared desirable.
Measles.—The number of cases of measles reported during the
year fell slightly from 411 in 1946 to 392 in 1947. The type of
disease was again mild, admission to hospital being necessary in
only a very small percentage of cases, and then almost invariably
for domestic reasons. As with scarlet fever, there is always the
danger that the virus of measles will increase in virulence and that
the severe type formerly responsible for so many unfortunate sequelae
and even death may return. Present evidence leads one to believe
that the comparatively large number of cases reported tends to
reduce the risk of increased virulence, and serves as a useful means
of maintaining the threshold of immunity at an adequate level,
while confining severity within reasonable limits. The use of
"measles modifiers" in one or other of the various forms has provided
us with a means of protecting contacts at a critical time. Used
properly, these modifying agents will adequately protect young
infants, delicate children, and hospital patients in whom an attack
of measles might be a serious event. Apart from such specialised
sections of the community it is now realised that the exclusion of
measles contacts from school or their segregation from other members
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