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the Medical Research Council in 1946 started a field investigation to try
to assess the value of a number of preparations. Their findings reported
last year were that each of the preparations used in the trials was of
some use, though some were markedly better than others. As the trial
was started in 1946 and as much work has been done on these vaccines
since, it is probable that to-day's preparations are even more efficacious
than those used in the trials. Although in some districts arrangements
had been made by which children could be immunised against whooping
cough, no general scheme had been practised in Harrow until more was
known about the efficacy of the preparations. It was felt that encouraging
mothers to have their children immunised against whooping cough
by preparations which might prove to be ineffective, might have weakened
the confidence of the mothers, and have had an adverse effect on the
arrangements for the protection of children against diphtheria. Since
1948, the responsibility for making such facilities available to children in
this district has rested with the Middlesex County Council as the local
health authority. The County Council had agreed to the facilities continuing
to be made available in those districts in which they had been
up to 1948. After considering the Medical Research Council's report on
the findings of the enquiry, the County Council has agreed to facilities
for immunising children against whooping cough being made available
in all parts of the county.
PUERPERAL PYREXIA
The condition which is notifiable is a rise of temperature to a certain
point occurring within a specified number of days of childbirth or miscarriage.
The raised temperature may not be associated in any way with
the patient's pregnancy or labour ; it may be the result merely of condition
such as a common cold. It may, on the other hand, be associated
with the pregnancy, being due to such causes as engorgement of the breasts.
The serious states, though, which may be the cause of the rise in the
temperature are infections of the genital tract. Such conditions may be
serious not only to the patient but to others, and may be of public health
significance, as there may be risk of spread of infection to others who
may be other expectant or nursing mothers in the same Nursing Home or
hospital ward, or may be other expectant or nursing mothers attended
by the medical or nursing attendants who are looking after the infectious
patient.
In general, the notification of an infectious disease is sent to the
Medical Officer of Health of the district in which the patient is at the
time the disease is recognised, so that most notifications of puerperal
pyrexia are sent to the Medical Officers of Health of the districts in which
the mothers are at the time of their confinement. In the case of mothers
who have been delivered in hospitals in London, and who develop puerperal
pyrexia, the notification is sent to the Medical Officer of Health
of the district in which the home of the patient is situate.
13 notifications of puerperal pyrexia were received during the year ;
three of them related to mothers who had been delivered in hospitals in
London. In only two instances was the rise of the temperature thought
to be due to an infection of the uterine tract.