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the collection of information is always valuable. But when the
collection of this information 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 heavy toll, not
perhaps of life, but of well-being and the ability to carry on a
useful even abearable existence. But in none of these instances
is notification required.This would surely seem a fruitful field
in which the modern epidemiologist might play a truly significant
part.
D i phther ia
For the tenth year in succession, no case of diphtheria was
notified in the Borough. The last death took place approximately
nineteen years ago.
The remarks set out in my Annual Report for 1956 relating to
immunisation apply equally today. We have now implemented the
suggestions which I set out in my report for 1956, replacing
immunisation against diphtheria and pertussis (whooping cough)
combined immunisation - by immunisation against diphtheria and
vaccination against pertussis (whooping cough) separately.
It must be admitted that our new system calls for more
visits to clinics or to private doctors by mothers who wish their
infants protected against diphtheria and pertussis (whooping cough}
as well as being vaccinated against smallpox. Although we are
keeping very careful records.it is not yet possible to state the
exact impact which the change-over from combined inoculations to
separate inoculations has had. Our own belief, however,, is that
mothers are accepting the advice given at our clinics, to the
effect that a few additional visits are much more than compensated
by the very full measure of protection afforded their
children.
In this connection, the Council will be interested to know
that 85% of Wood Green children who attained the age of two years
by the end of 1955, had been immunised against diphtheria. By
the end of 1957,the latest figures available, this percentage had
risen to 88%.
It is hoped that when vaccination against poliomyelitis
assumes the proportions which immunisation against diphtheriahas
now reached, it will be safe to resumeonce more protection against
diphtheria and pertussis (whooping cough) by the combined method.
Indeed, one might even hope that a triple or even quadruple antigen
will eventually be available, affording protection against
diphtheria, pertussis (whooping cough) and possible tetanus, in
a single series of inoculations.
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