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"So far as the remainder of the table of infectious diseases
notified during the year is concerned, it is pleasing to note that
the number of cases of pertussis (whooping cough) fell from
150 in 1956 to 73 in 1957, an indication, we hope, of the
extensive immunisation programme being carried out in South'
gate. Cases of dysentery fell from 39 to 13, but here the
classification of 'dysentery' as set out on notification forms is
so wide as to have limited practical significance. Cases of
poliomyelitis rose very slightly from 7 to 9, a satisfactory
outcome in view of the fact that polio was particularly
prevalent throughout the country in 1957.
"Whenever I study infectious diseases tables, I am more
than ever convinced that our whole system of notification
should be completely overhauled. At the moment we receive
notifications of diseases such as measles, where we act virtually
as a post office only; erysipelas which has little or no clinical
import these days; puerperal pyrexia which may very well
be due merely to constipation or a slight cold during the
puerperium; malaria whose significance entirely escapes me ;
and several other diseases which, although admittedly
infectious, have extremely little communal or epidemiological
significance. One must admit that the collection of information
is always valuable. But when the collection of this inform'
ation means that other work must either be neglected or pushed
aside, when the cost involved might very well be devoted to
other, more important projects, it would seem that the time
has come to act. And there is yet another aspect of the
problem to consider. The diseases which I have just
mentioned are no longer killing agents, with the possible
exception of pertussis (whooping cough) in very young
children and paralytic poliomyelitis. Even here, the death rate
is not at all high. Yet the death rate for such diseases as
coronary thrombosis and lung cancer is steadily rising among
important age groups in the population, while the aggregation
of diseases commonly grouped under the term 'rheumatism'
continues to take an extremely heavy toll, not perhaps of life,
but of well-being and the ability to carry on a useful even a
bearable existence. But in none of these instances is notifica'
tion required. This would surely seem a fruitful field in which
the modern epidemiologist might play a truly significant part."
Diphtheria.
For the tenth year in succession, no case of diphtheria was
notified in the Borough. The last death took place approximately
fifteen years ago.
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