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with one death. There was then another lull until the one case occurred
in the middle of November.
In all, then, there were 30 cases, of whom four died; 10 suffered
from a non-paralytic attack, of whom two suffered from polioencephalitis.
The sexes were equally affected. Ten of those attacked were under five
years of age, eight were between the ages of 5 and 15, while twelve
were over 15. The youngest attacked was a child of four months; the
oldest a man of 46.
There was one instance of a family grouping. On the 16th September
a child of seven was admitted to hospital suffering from a paralytic
attack, his paralysis having appeared on the 15th. In the same house
was a child of 11 who fell ill on the 11th September with a non-paralytic
attack and on the 16th September a brother, aged four, fell ill, also with
a non-paralytic attack.
' It has for long been accepted that it is advisable not to carry out
any but the most urgent operations on the throat during periods of
poliomyelitis prevalence. The attention of those at the local hospitals
which provide this treatment for the local population was drawn at the
appropriate time when it seemed the district was entering its period of
poliomyelitis prevalence. Operations on the throats of children were
largely discontinued at these hospitals for a period of some weeks.
Reports from abroad and from this country seemed to point to there
being an association between the onset of poliomyelitis in some children
and their recent inoculation. At first this association appeared to be
only when a child had been inoculated with pertussis vaccine. Later
reports suggested that there was a risk, though a reduced one, when a
child was inoculated with APT to protect him against diphtheria. No
reports of any such cases had been received in this district. Nevertheless,
it seemed that there was a risk, though of unknown magnitude, so for a
time the inoculation of children against whooping cough and diphtheria
was discouraged.
ENCEPHALITIS
Two cases of encephalitis were notified. One patient who was
thought to be suffering from an encephalitis secondary to mumps was
later recognised to have suffered from cavernous sinus thrombosis.
MEASLES
Although 1950 was not an epidemic year for measles, the district
was not entirely free from the disease for any part of the year. The curve
of incidence was a shallow symmetrical one, rising from an average
weekly incidence of one, in January, to nearly 60 for each of the last two
weeks in May and the first two weeks in June, falling then slowly to an
average of two in November. In the last weeks of December there was a
sharp rise, the prelude to the outbreak of 1951. In all, 1,005 notifications
were received. The disease, in the main, was mild in character. That
the heavy incidence occurred in the warmer months would naturally
result in a lessened incidence of some of the complications of measles;
three patients died, but two of these were children resident in an institution
outside the district.