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CHAPTER V.
INFECTIOUS DISEASES.
1. SERVICES PROVIDED, Notification, investigation,
pamphlets issued on the various infectious diseases, exclusion
from school of patients and contacts, advice re milk handlers—
Disinfection — Hospitalisation generally at Hendon Isolation
Hospital, re puerperal pyrexia and ophthalmia neonatorum, London
County Council, re poliomyelitis at Royal National Orthopaedic
Hospital, re smallpox, Middlesex County Council—Notification of
tuberculosis—Compilation of tuberculosis register—Weekly and
quarterly returns to Ministry of Health and County Medical
Officer — Preventive medicine, diphtheria immunisation, antityphoid
inoculation, whooping cough immunisation (for children
about to enter, or in, Day Nurseries), anti-smallpox vaccination—
Food poisoning notification and investigation—Scabies, arrangements
with Royal Borough of Kensington—Complete bacteriological
service available at Central Public Health Laboratory, Colindale,
outfits distributed from Public Health Department—anti-toxins
available diphtheria, tetanus, scarlatina.
2. A circumscribed outbreak of acute Poliomyelitis occurred
in the Borough during the year, when 26 cases in all were notified.
The main incidence fell in August and September but notifications
were received from March to October. Many of the cases were
frank examples of the disease and several were followed, by more
Gr less extensive degrees of paralysis. At the onset of the cooler
weather, fortunately, the outbreak appeared to 'become self limited.
3. The supervision of contacts landing from ship or aeroplane
called for routine surveillance of 26 persons regarding smallpox
and 9 persons regarding cholera. Constant vigilance must be
given to persons arriving from infected foreign areas and this
supervision must be given with discretion and understanding.
Many such ask advice on the pertinence of vaccination for the
members of their families. It is always wise to reinforce previous
vaccination at intervals. Vaccination, therefore, of any member
of the family who has not been successfuly re-vaccinated within
the last two or three years would be a wise proceeding. With
regard to those who have never, so far, been vaccinated, however,
the advice is given that vaccination should not be performed unless
there has actually been contact with smallpox and, of course,
the position generally is that the person ibeing supervised has only
been a contact or a possible contact, and is not suffering from
smallpox. This advice about waiting for actual contact with
smallpox before vaccination for the first time applies especially to
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