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61
SMALLPOX.
A few contacts of cases came to the district and were kept under
surveillance for the usual period. For freedom from outbreaks of smallpox,
reliance cannot now be placed on the vaccinal state of the community,
as this is admittedly very low, but rather on the active efforts to ring off
a detected case. Control is far easier when the type is the more severe
typical smallpox, which is that likely to be imported from abroad, than
when it was the mild variant which overran the country a few years ago.
TYPHUS FEVER.
This, a louse-borne infection, is one of the diseases liable to be imported.
In the present state of health of the country any large outbreak is
most improbable. Air travel increases the risk of importation, so visits
are paid to the homes of those about whom information is received that
they have recently arrived by air from a suspected area.
MALARIA.
At one time endemic in large areas of this country, this disease, while
probably remaining the most important of tropical infections, is ordinarily
of minor importance here, although in areas the vector mosquito is
prevalent. For the conveyance of this disease three conditions are
necessary : the mosquito must, within a period of some 15 days, have
bitten a person suffering from malaria ; the person must have had in his
blood the sexual forms of the malarial parasite ; and the atmospheric
conditions, particularly temperature, must be favourable to the mosquito.
The return to this country of large numbers who, having contracted
infection abroad and during their relapses, have the parasites in the proper
stage of development in their blood stream, leads to a risk of conveyance
of infection in those areas in which appropriate mosquito is present.
Under the 1919 Regulations malaria was made notifiable, but not in
those cases occurring in an institution in which infection had been induced
for therapeutic purposes, unless on discharge the patient was liable to a
relapse. (Certain diseases are treated by the therapeutic introduction
into the bloodstream of malarial parasites with a view to inducing a
clinical attack of malaria.) The return of many men from service in
countries in which malaria is common has resulted in many notifications
of the disease being received on the occurrence of a relapse. Apart from
three in service personnel, eight notifications were received in 1945, in
every one of which the patients were suffering here from a relapse of an
infection contracted abroad.
ENTERIC FEVER.
Each year a small number of cases of the enteric infections is notified.
These have usually been due to the paratyphoid organism. The cases
have occurred sporadically and no two seem to be related in origin. In
the six years 1934 to 1939 the numbers recorded were 7, 5, 5, 2, 2 and 7.
In 1940 two notifications were received ; then in 1941 the large increase
to 17. This prevalence, which was due to a paratyphoid infection,
formed part of a heavy incidence throughout the country, being indicative
of the lower hygienic standards in food production, distribution and