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7
Whooping cough
The incidence of whooping cough rose in 1960 compared with the previous year, but the case rate
per 1,000 population (1-7) was only a little above that of England and Wales (1-3) (Table 14).
Dysentery
There was a marked decrease in the number of cases of dysentery compared with the previous year,
although in England and Wales there was an increase. With the exception of 1957, when there were only 13
confirmed cases, it was the best year since 1951. Generally, however, the disease is much more prevalent
than before the war. It is usually a mild disease causing no deaths but it can produce some disruption and
discomfort in the life of the community.
There were two small outbreaks:—
(1) The first occurred at Essex Road Day Nursery on the 26th April. Altogether 10 children were affected.
They were all excluded and two were admitted to Isolation Hospital for treatment. The infection was
quickly cleared up and all the children were re-admitted by the end of May.
(2) The second outbreak occurred at the Gladstone Park Day Nursery on the 16th May. Altogether three
children and one member of the staff were affected. They were all excluded from the nursery and one
child was admitted to Isolation Hospital for treatment. The infection was quickly cleared up and they
were re-admitted by the end of June.
In 1951, as a result of a study made in schools, investigations to discover carriers were discontinued
in order not to disturb the children's schooling. Because day nurseries are relatively closed communities,
the stools of all children were still examined and carriers were excluded until they had three consecutive
negative stools taken at two-day intervals. This upset the work of mothers and staff and placed a heavy
burden on the Public Health Laboratory Service. Also matrons and staff tended to rely on these examinations
for safety, but now when only suspected cases are excluded they appreciate more fully the need to supervise
personal and general hygiene. As an experiment the same procedure in schools was adopted in these two outbreaks:
carriers were not searched for, and only children with symptoms were excluded until bacteriological
examinations showed them to be non-infective. It is unlikely that the exclusion of carriers would have made
any great difference to the extent and length of the outbreaks, and it certainly would have disrupted the work
of the day nurseries and of factories where the mothers work.
Poliomyelitis
There were 3 notified cases of poliomyelitis, all of which were confirmed (3 paralytic) (Table 15).
This was the best year since 1951, when 5 cases were notified but none was confirmed.
Food poisoning
There was one outbreak of food poisoning (see page 12).
Puerperal pyrexia
Since 1st August, 1951, puerperal pyrexia 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'. There was a slight increase in the number of cases in 1960.
BRONCHITIS, CANCER OF THE LUNG AND TUBERCULOSIS
(Tables 16-25)
Today serious respiratory diseases should be considered together, because of their common causes ;
lungs already damaged may have a lowered resistance to infection or worse still cancer. The major common
cause is smoke—from cigarettes and the atmosphere; over the last few years much evidence has been produced
for bronchitis, tuberculosis, and particularly for cancer of the lungs.
We have been successful in the attack on tuberculosis because of the wide use of effective drugs.
Cancer, however, presents a different picture because cigarette smoking is still widespread, and treatment,
except in the early stages of the disease, is rarely satisfactory.
Over the last fourteen years, bronchitis and cancer have displaced tuberculosis as an important
cause of invalidity and death. In Willesden the death rates from cancer of the lung and bronchitis in 1960
were nine times that from tuberculosis (Tables 17, 18 and 19).
Early diagnosis of chest diseases is essential if treatment is to be effective, but a change in social
habits is necessary if we are to eliminate them. Health education and social reform can also help: young
people have been given talks on chest diseases, and in particular on the dangers to health and life from
smoking cigarettes.
Mortality and morbidity
There were six deaths from tuberculosis among men and five deaths among women, with the now usual
shift to the older age groups. For the second successive year there were no deaths from non-pulmonary
tuberculosis. There has been a slight fall in notifications of tuberculosis (Table 16) compared with last year
and a decrease in the total number of cases on the register at the end of the year. However, the figures are
small and cannot indicate that tuberculosis has been defeated.