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Prevalence and Control of
Infectious Diseases
From the table of Infectious Diseases set out on page
it will be seen that 809 cases of infectious disease were notified
during the year, as against 1,156 in 1948 and 887 in 1947. The
infectious sickness rate for the district was 11.18, as compared with
15.62 in 1948 and 11.93 in 1947.
For some time past it has been more and more apparent
that the Infectious Sickness Rate has no real epidemiological significance.
This rate is very largely governed by the prevalence of
measles in any given area and provides little, if any, indication
of the trend of infectious diseases generally.
It is interesting to note the change in the infectious diseases
picture which has taken place within the last few decades.
Although, perhaps, not presenting quite such a dramatic comparison
as that between, say, 1849 and 1949, the changes which
are taking place are none the less interesting and significant.
When I came to Southgate in 1931, diphtheria was a serious
disease, taking its toll of life almost every year and presenting
what seemed to be a permanent and major problem. Scarlet fever
was, on occasion, a serious disease, with crippling sequelae.
Admission to hospital had to be arranged in a fairly substantial
proportion of measles and pertussis cases, in which bronchopneumonia,
otitis media, and other complications were relatively
common. Typhoid infections, usually sporadic, occurred at regular
intervals; while variola minor (the mild type of smallpox) was
prevalent throughout the country, especially in and around London.
Today the picture has materially altered. Diphtheria has
been eliminated from the list of major infectious diseases which
one expects to meet, although, when it does occur, the severity and
fatality rates show very little alteration. Scarlet fever, on the
other hand, although just as prevalent now as in 1931, is very much
less severe. Complications have been materially reduced, while the
more serious forms of septic and toxic scarlet fevers are very rarely
encountered. Measles and whooping cough have also shown a
reduced severity, although, once again, the incidence is very little
changed.
Variola minor has disappeared, its place being taken by occasional
importation of the severe Asiatic form of smallpox.
Individual cases of typhoid and paratyphoid fevers are much less
common, although outbreaks still occur. Food poisoning outbreaks
have increased, almost certainly to a greater degree than
improved facilities for diagnosis and methods of recording would
explain. Of more immediate significance poliomyelitis, previously
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