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fumigation and removal of bedding and other articles for stoving after
the commoner notifiable infections shall be abandoned, the householder
being instructed as to the precautionary measures to be taken. Where
householders still request that fumigation or stoving be carried out, a
charge is made, 7s. 6d. for fumigating the room, and 10s. Od. for the
stoving of the first load, 5s. Od. for any subsequent load. It was later
decided that terminal fumigation and stoving of articles should be carried
out free of cost in the case of open tuberculosis and of scabies. Experience
during the war showed that the risk of transmission of infection in scabies
by clothing is very much less than it had been thought to be. Although,
then, when the incidence of scabies rose so markedly in the earlier of the
war years, arrangements were made for the stoving of the clothing, the
practice was later modified, as ordinary laundering of under-garments
was considered sufficient in most cases. In regard to the treatment of
premises which have been occupied by those suffering from open tuberculosis,
it is felt that in this even more than in the other infections, it is
essential that the premises should be thoroughly cleansed beforehand,
otherwise the organisms are too likely to be protected against the action
of the disinfectant. The practice has been adopted, then, through the
kindness of the staff of the chest clinics, of a report being obtained from
them that the other steps have been taken and the premises cleansed.
On receipt of this report, but not until then, arrangements are made for
the treatment of the rooms and their contents.
DIPHTHERIA.
Incidence.
Not a single person in Harrow suffered from diphtheria in 1948;
11 patients were notified to be suffering from the infection and admitted
to hospital, but in not one of these cases was the diagnosis confirmed,
each one of them suffering from streptococcal infection of the throat.
Although in some years only a few persons succumbed to the disease, this
is the first time it has been possible to record the absence of the infection
for an entire year. Only a few years ago, a district with Harrow's population
would be expected to have anything between 200 and 400 cases
in a year. Of these, between 10 and 40 could have been expected to have
died.
It is common knowledge that throughout the country the incidence of
and the fatality from diphtheria have fallen markedly in recent years,
a decline which has coincided with the increasing extent to which children
have been immunised against diphtheria. Although in some districts
facilities for protecting the children have been available since the late
1920's, it was not until the national campaign started during the war that
the practice became general throughout the country. The fall in the
number of notifications in the whole country during the past few years,
although quite dramatic, had not been here on the same scale as happened
in parts of America where for a time the disease was virtually
obliterated. While other factors such as a decline in the invasiveness
of the organism may have played some part in the fall of incidence, it is
generally accepted that the main factor is the extent to which the children
have been immunised.