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of the problem so that we can study it more fully It is by no
means certain of course that this study would bring forth the
much needed answers but we would at least have the satisfaction of
trying to establish whether or not there was any factor in the
district which had significance After all, the sum total of the
facts ascertained in many districts might eventually be scientifically
related to the vast amount of medical research which is
taking place in so many hospitals and laboratories.
It is certainly a fact that the infectious diseases picture
presented today is radically different from what it was only a few
decades ago One has only to look at the use which is being made
of the older type of isolation hospital to realise this today
Yet the pattern of notification has altered very little One appreciates
that this is a gigantic problem with many ramifications
But it surely represents a problem which can and should be vigor
ously tackled on a national level In other words the horizon of
the term epidemiology has widened almost beyond recognition
Diphtheria
For the eleventh year in succession no case of diphtheria
was notified in the Borough The last death took place approximately
twenty years ago
Our campaign of immunisation against diphtheria has been
carried on throughout the year along the general lines set out in
my Annual Report for 1957 We are still continuing to give separate
protection against diphtheria and pertussis (whooping cough) in
the belief that the protection afforded by vaccination against
poliomyelitis is not yet sufficiently advanced to remove the poss
ible danger of provocation poliomyelitis I am very pleased to be
able to report that Wood Green mothers have freely accepted our
advice and are attending with their infants as often as is neces
sary at clinics or at their own doctors surgeries to have their
children protected against diphtheria and pertussis separately
and also vaccinated against smallpox As the necessary number of
visits including vaccination against poliomyelitis does not
entail more than one visit each month to a clinic or to the family
doctor it can scarcely be said that an intolerable burden is
being placed on the shoulders of mother or children!
Detailed records kept in the Area Health Office show that
91% of Wood Green children who had reached the age of two years
by the end of 1958 had been fully protected against diphtheria
These figures are eminently satisfactory and speak for themselves
Indeed they represent levels of immunisation which not so many
years ago would have been considered virtually unattainable They
obviously redound to the credit and intelligence of our mothers
who appreciate to the full the advantages which protection against
such diseases as diphtheria pertussis (whooping cough) poliomyelitis
and smallpox will impart to their infants
Scarlet Fever
Seventy-seven cases of scarlet fever were notified during the
year as compared with 22 cases in 1957 and 17 cases in 1956,
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