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12
Whooping Cough
550 cases were notified in 1951 (543 confirmed), but a total of 662 (349 were children under the age
of 5 years) came to the notice of the health visitors. There were no deaths from whooping cough.
Pneumonia and Influenza
172 cases of pneumonia were notified in 1951 (161 confirmed). There were 102 deaths from bronchopneumonia,
lobar pneumonia and pneumonia (unspecified), and 35 deaths from influenza.
Ophthalmia Neonatorum
1 case was notified in 1951 (a case rate of .39 per 1,000 registered live births); there was complete
recovery with unimpaired vision.
Puerperal Pyrexia
75 cases of puerperal pyrexia were notified during the year (73 confirmed).
The definition of puerperal pyrexia was modified as from the 1st August, 1951, and a new form of
notification introduced. Puerperal pyrexia now applies to any " febrile condition occurring in a woman in
whom a temperature of 100 4 degrees Fahrenheit (or 38 degrees Centigrade) has occurred within fourteen
days after childbirth or miscarriage."
Food Poisoning
27 cases of food poisoning were notified during the year (10 confirmed).
TUBERCULOSIS
Tuberculosis still remains the most important infectious disease of the borough. Although there has
been a decline in the incidence of tuberculosis in Great Britain since 1950, there is already some evidence
from the Willesden figures that the decline may soon be halted.
The death rates in Willesden show a further welcome reduction, although not so marked as in previous
years. The main disappointing feature, however, is the continuing rise in the case rates over the past two
years : they now show an increase over the pre-war rates (see Table I). The age groups most affected (see
Table II) are those from 20-55. The age group 15-20, comprising in the main those who have just left school,
show an appreciable increase in the numbers suffering from pulmonary tuberculosis but the striking increases
begin with the age group 20-25 ; and they continue until 35 for females and until 55 for males. Greater
attention is correctly directed to the younger age groups because it is particularly at this period that tuberculosis
can be so harmful. The young adult finds that he has to leave his work or training at the critical
period when he is learning a trade or building a home and a family. It must be appreciated, however, that
tuberculosis attacks many people over the age of 55, and its influence at this age cannot be ignored.
The general increase in the number of cases may be partly accounted for by earlier and more accurate
diagnosis. Although to-day cases are more often detected in an earlier phase of the disease, a large proportion
of cases (about one in five) still die unnotified, and together with those which die within a year of
notification, make up almost half the cases which die from the disease (see Table III). Admittedly,the actual
numbers of deaths are lower, but the percentages of undiagnosed or late diagnosed cases cannot be deemed
satisfactory.
There were not many mass miniature radiography surveys in the area or in the neighbourhood in
1951, and they did not make any appreciable contribution to the number of early cases detected. Mass
miniature radiography could probably be used to a better purpose if attention was directed to the suspected
sections of the community rather than to unselected groups. The following sections of the community should
have special consideration : persons who are suspected of disease in the lungs, particularly those under the
care of their family doctor; contacts of infectious cases of tuberculosis; persons whose lungs are subjected
to noxious fumes and gas fumes; health workers, e.g. nurses and medical students; expectant mothers at
ante-natal clinics; all hospital admissions and out-patients; and entrants to the armed forces.
It must always be emphasised that a negative X-ray finding is no guarantee that the disease may not
be contracted at a later date and consequently a further examination should be arranged as soon as
symptoms warrant it, even if the previous X-ray was of recent date. Another danger in dealing with unselected
groups is that many minimal shadows are revealed in persons who would have recovered apart from
treatment, and thus needless anxiety is frequently caused and valuable time and energy wasted. Unfortunately,
it is not possible at this stage to differentiate between those patients who have a high resistance and
will recover without treatment and those who will not. Those without any symptoms at all are most likely
to recover completely without treatment.