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15
DIPHTHERIA.
Incidence.
Fifty-seven notifications were received during the year of cases occurring
amongst the civilian population. In the vast majority of these
though the patient was in fact suffering from some other condition,
mostly tonsillitis. The corrected figure of 16 is a rate per thousand
population of 0.08 compared with the national rate of 0.58. The corresponding
figures for the years 1934 to 1943 ranged from 0.20 to 0.60.
Four cases occurred in one family, one proving fatal, the infection
probably originating in a missed case. Two cases occurred in another
family, again one proving fatal.
One patient was suffering from laryngeal diphtheria.
Of the cases proved to be diphtheria, 20 per cent. were under 5 years
of age and 80 per cent. were of school age, none being over 15.
Place of Treatment.
All but one child who was treated at home were admitted to the
Harrow Isolation Hospital.
Deaths.
Two cases proved fatal, one a child of 20 months, not being treated
till the sixth day of illness, the other a boy of 5 years who was not treated
until the eighth day.
Immunisation.
There was a marked falling off in the number of children immunised
in 1944, only 2,359 being treated as compared with 5,427 in 1943, 7,366
in 1942, and 6,858 in 1941. Of these, 1,327 were treated at infant welfare
centres, 149 at the local war nurseries, 795 by general practitioners and
only 28 this year at the local elementary schools.
The fall in numbers is less serious perhaps than might appear because
it occurred mostly amongst those of school age. As a contrast, the figures
of those treated at the infant welfare centres are well maintained, being
1,327 in 1944, against figures of 1,532, 1,977 and 1,184 for the years 1943,
1942 and 1941. Practically all these will be children of under five years
of age, the vast majority being done at about the ideal age of near the
twelve-month.
It is now expected that sufficient children of school age have been
immunised to make it most unlikely that there can be any extensive
outbreak of diphtheria. In many areas though the percentage of underfives
immunised is greater than the proportion amongst school children.
This means that for a number of years the position in regard to school
children even though no further immunisation were to be carried out
would improve. Efforts then should be directed to maintaining a high
standard of immunity in the under-fives. The position in this district
in this regard is not unsatisfactory, and it is for this reason that it is felt
that although there has been this falling off in the total number treated,
there is no cause for disquiet in that the position of the under-fives is
not deteriorating.