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69
WHOOPING COUGH.
While not exhibiting the marked periodicity of measles, whooping
cough is a disease which attacks districts in large outbreaks and then
completely disappears. It has been notifiable since the latter part of
1939. The number of notifications received in 1940 was 296, and in the
succeeding years 1,259, 468, 468, 683, 220, 441 and 521. In 1948, the
disease smouldered throughout the whole year, the average weekly
notifications in the first quarter numbering 15, in the second 20, in the
third 7, and in the last 2. Many schools were attacked in the first months
of the year, but none of them especially heavily. There were four deaths
from whooping cough, all of them of infants under 12 months of age.
The same practice in regard to visiting is carried out as in the case
of measles, the health visitors paying 36 visits to the homes of those
affected. Again, while it is not necessary that all sufferers shall be
admitted to hospital, it is essential that these facilities should be available
for those suffering from some of the complications of the disease or those in
homes where nursing is difficult or the home conditions are not good.
Eight patients were admitted to the isolation hospitals.
The Local Health Authority is empowered under the provisions of the
National Health Service Act to arrange for the immunisation of people
against certain diseases. The County Council has decided not to use
these powers to offer facilities for protecting children from whooping
cough throughout the county. On the other hand, in certain areas
before July 5th, 1948, the local authorities had already made these
arrangements. Then, again, some areas are taking part in the investigations
carried out by the Medical Research Council as to the efficiency
of certain preparations. In these ways, then, the parents in some parts
of Middlesex can have their children inoculated against whooping cough
free of cost under the arrangements of the County Council, but in others,
including this, these facilities are not available.
It is hoped that the investigations will be sufficiently encouraging
to justify the authority offering these facilities throughout the county, as
although the number of deaths attributed to whooping cough might be
small, the probability is that the disease in fact causes the death of many
more, while in addition it results in much acute illness and in much
invalidity amongst those who have recovered.
PUERPERAL INFECTION.
As defined by the regulations which call for the notification of this
condition, puerperal pyrexia is any febrile condition occurring in a
woman within 21 days of childbirth or miscarriage, in which a temperature
of 100.4° F. has been sustained for 24 hours or has recurred within
that period. While the raised temperature might be the result of an
infection of the birth canal, or might be due to some other condition
associated with the pregnancy, such as an inflamed breast or inflamed
varicose veins, it might also be due to some condition, such as influenza,
entirely unrelated to the pregnancy. Many of the notified patients
are removed to isolation hospitals for treatment. This is especially
necessary if the febrile patient is in a nursing home and some innocent