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who visited A have exposed themselves to the risk of infection.
This theory would do a lot to explain the fact that case to case
infection appears to be very rare, for example the unusualness
of more than one case in a household and the fact that hospital
staffs are not particularly prone to the disease. Unfortunately
we are still floundering in the dark as to possible foci of infection
and although many ingenious theories have been advanced, I still
adhere, in the present state of our knowledge, to the view that
human carriers are the most likely source of infection. Before
leaving the subject, a word should be added about immunity,
at present we have no test to determine whether or not an
individual is susceptible to infantile paralysis. It may well be
that the majority of people have a natural immunity to the
disease, which could explain why only one person in a household
is usually affected, but if this is so, the increased number of cases
in the community of recent years can only be explained by the
fact that there are more foci of infection now than there were
formerly. This might well be the case, with the increased intercontinental
travel of modern days, by means of which healthy
carriers could import the disease into this country from other
countries where it is endemic.
From the above remarks it will be clear that although the
problem of anterior poliomyelitis is as yet unsolved, there are
lines of approach which it is hoped will bring forth fruit in the
not too distant future.
SCARLET FEVER.
One hundred and fifteen cases were notified (139 during
1949), fifty-two of which were treated in hospital and sixty-three
were home nursed.
There were three " return " cases.
The infection continued to be mild in character and no deaths
from this disease were recorded.
The continued lack of seriousness in the symptoms of this
disease in the majority of cases, gives just cause for gratification,
but whether this is a temporary or permanent feature will only
be able to be judged with the passage of time. If one studies the
incidence and life history of scarlet fever over the years, it is
a striking fact that both have been subject to periodical waves
of alternating seriousness and mildness and it may well be that
we are now in the trough of the wave with the crest to be found
at some future date. Whether this present attenuation is due
to a building up in the resistance of the population or to a
weakening in virulence of the infecting organism is not clear.
but whatever the cause. the possible course of this disease will
need constant vigilance.