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the commoner notifiable infections is not carried out by the Council, the
household being instructed as to the precautionary measures to be taken.
Where householders still request that fumingation 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, and 5s. Od. for any subsequent load.
The change in practice in regard to the routine fumigation of premises
after the occurrence of a case of infection followed on the altered emphasis
of the importance of the human spreader as opposed to the inanimate
object. Nothing that has happened, following the virtual abandoning
of the practice, has led to the need for any reconsideration of the decision.
There has been no increase in the incidence of the secondary cases which
might be accounted for by infection by inanimate objects. Today, more
importance is being attached to the risk of spread, not directly from
the nose and throat of spreaders, but indirectly, either by means of
contaminated hands or by the stirring up of the dust of bedclothes or on
floors. It may be that some of the invasions, the spread of which are
unaccountable, will be found to be the result of the passage of organisms
in this way. As yet, though, it does not seem to have been demonstrated
that the dust-borne spread of haemolytic streptococcus infections is a
very important factor. If it should be shown to be, then possibly ideas
about the treatment of premises occupied by infective persons might have
to be revised again.
DIPHTHERIA
Of the twenty-six persons who were thought to be suffering from
diphtheria during the year in only one was the diagnosis confirmed;
this was a boy of three years of age who had not been immunised. This
was the first case of faucial diphtheria in the district for over three years.
In 1948 there were no cases, and in 1949 the only sufferer was a child,
who had a nasal infection.
Eleven of the suspects were suffering from tonsillitis, eight from
glandular fever and three from laryngitis.
Immunisation of the child population against diphtheria must have
contributed largely to the virtual elimination of the disease. Anyone
who has reached a state of relative immunity, so that he no longer
succumbs to a dose which in the susceptible would result in infection,
can, in general, maintain that immune state only if his tissues have to
react to attack. When diphtheria was not the uncommon disease that
it has become in many parts of the country today, the state of immunity
of many was maintained at an adequate level by the individual being
subjected to sub-infective doses of the organisms by his coming into
contact with spreaders of the germs. Today, however, that is not the
position, and many a child who has been satisfactorily immunised,
because he is deprived of the opportunity of being exposed to these
organisms, runs the risk of losing his immune state. That is why it is so
necessary that those immunised in infancy should receive boosting doses
at certain intervals.
A population which contains a high proportion of immune members
will have few or no cases of disease. The result of this is that the many
who have been protected reduce the risks of those not immunised from