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PREVALENCE AND CONTROL OF INFECTIOUS DISEASES
Prom the table of infectious diseases set out on page 34, it
will be seen that 1,111 cases of infectious disease were notified
during the year, as against 265 in 1956. The Infectious Sickness
Rate for the district was therefore 22.44 as compared with 5.29
during the previous year.
As I have mentioned on previous occasions however, the
Infectious Sickness Rate for any district has lost most of its
significance. This rate is almost entirely governed - at least
during any normal year - by the fact of the period under review
being or not being a year during which measles was prevalent.
It need scarcely be said that 1957 was in fact, a measles year,
876 cases being reported as against 27 during 1956,
It must be frankly admitted that so far as measles notifications
are concerned we merely receive these notifications and
do little more, unless we are specifically asked to do so by a
general practitioner or by a parent- And this it may be observed
is an extremely rare occurrence.
In the case of scarlet fever notifications we do of course,
control the contacts of food handlers while we still carry out
disinfection when and where this, is requested or required. But
here again it must be appreciated that what we do now is more,or
less infinitesimal compared with what we did not so very many
years ago. Indeed in my submission having regard to all the
circumstances, the only justification for continuing the notifi
cation of the disease which we know as "scarlet fever" is the fact
that, at any time the more severe type may arrive back in this
country and will then require rigorous supervision The notification
of "scarlet fever" seems even more illogical when it is
remembered that streptococcal infection of the throat without a
rash is not notifiable but is generally assumed to be more or at
least equally infectious It must also be borne in mind that many
cases of the present mild type of scarlet fever arenever notified
at all. Indeed in quite a number of instances it would seem that
the existence of the disease is never even suspected
So far as the remainder of the table Is concerned it is
pleasing to note that the number of cases of dysentery fell from
76 to 32, It must, however be borne in mind that 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 5 to 6 a satisfactory outcome in view of
the fact that poliomyelitis was reasonably widespread throughout
the country during 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
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