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with the patient are fully protected there is no spread ; but this is likely
only if substantial proportions of the population are not only vaccinated,
but re-vaccinated. It is most desirable then that re-vaccination should
be carried out as routine practice, such as on the entry of a child to school
and again on his leaving.
ENTERIC FEVER
There were three cases of enteric fever in this district in 1953. The
first case was that of a boy of seven who fell ill on January 1st with what
clinically was an attack of typhoid fever. Laboratory results were negative,
but this may be because even before the eruption of the typical
rash he had been given chloramphenicol. The second case was an adult
woman who fell ill on January 29th. Laboratory findings in this case
confirmed the diagnosis. The third patient, an adult male, fell ill on March
9th with paratyphoid fever.
This is the usual history of this infection in this district, a small
number of cases occurring each year, apparently not connected in any
way one with another, and in most instances no association with other
cases being found and the source of infection not being discovered.
DYSENTERY
13 persons were notified during the year to be suffering from dysentery.
The diagnosis was not confirmed in three instances. On each occasion
when the organism was recovered it proved to be of the Sonne type.
That the notifications received are no true indication of the extent
of the infection is suggested by the fact that enquiries at the households
of the patients notified brought to light others in the family who had
suffered from a similar condition ; for instance, enquiries at the home of
an adult woman who had been admitted to hospital and the Sonne
organisms recovered showed that a number of children in the house had
been ill before their mother succumbed ; similarly enquiries into the origin
of illness in a girl of 15 elicited the fact that her father had previously
had diarrhoea for several days. Infection by the Sonne organism is
probably very common. It will be only a proportion of those attacked
who react clinically, only some of those who do react will go to their
doctors, and only a proportion of those who attend will be notified.
FOOD POISONING
Only seven persons of those living in the district were notified last
year as suffering from food poisoning. The first was a child who was
suspected to be suffering from dysentery, but on laboratory findings
the diagnosis was changed to food poisoning. The second case was an
adult woman ; enquiries following her notification led to the department
learning that she was a member of the kitchen staff of a local hospital at
which nine patients and two other members of the staff had fallen ill
at about the same time, all suffering from diarrhoea and vomiting; all
recovered after a short illness. In the third patient it seems that the
diagnosis of food poisoning was made as the result of the bacteriological