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77
killing disease. Here part of the improvement may be due to the improved
treatment being able to ward off complications or rendering such complications
as occur less dangerous. Though less prevalent than measles,
whooping cough accounts for more deaths and is the most damaging of
the notifiable infectious diseases in childhood. As contrasted with measles
for which there is no active preventive, there is one for whooping cough,
though probably it is not nearly as effective as that against diphtheria.
It is too early to say yet whether the use of this preparation is having any
marked effect in protecting the child population against having this
serious complaint. Whilst killing only a few, it results in serious damage
to so very many of those who recover.
The figures for poliomyelitis are typical of those of the country as
a whole. Up to recent years all parts of the country would be free from
the disease until well into the summer. The number of cases notified each
week would steadily increase to reach a peak in late September or October,
after which there would be a fall to extinction by the end of the year or by
the beginning of the next. That was the position until 1947, when the
country as a whole was invaded for the first time. The extent of this
invasion made it very likely that the country would not return to the
previous pattern of attack. The local figures reflect the fact that the
country has been invaded each year since 1947. In fact, as contrasted
with the position before 1947, the country since that date has never been
entirely free from attack as although the curve of incidence falls in the
earlier months of the year it never falls to zero, and after reaching a minimum
of some 20 notifications each week in March, the incidence starts to
rise again.
The incidence of cerebrospinal fever which was low each year, rose
sharply in the earlier part of the war years. The local figures support
previous findings of the association of this disease and war because the increase
did not occur until after the war had started. The national figures
though show that the rise had in fact started before the war, so that
although perhaps in the absence of war conditions the incidence would
not have reached the heights it did, there would have been in those years
a prevalence of something more than had occurred in the early nineteenthirties.
The figures for enteric fever are fairly steady, most relating to cases
of paratyphoid infection, but a few to typhoid fever. Apart from the
occurrence of two cases in one house in two instances, all the 18 cases
that occurred in 1941 appeared to have no connection one with the other.
Of the 21 cases which occurred in 1947, all but four were children or staff
at a children's home in the district. The figures for dysentery and food
poisoning in all probability bore no relationship to the true incidence
of these complaints. It is likely that the higher figures of recent years
are not so much the result of an increased prevalence as to more cases
being recognised because of the greater attention being paid to the subject
of the clean handling of food and of food poisoning.
The war years saw a sharp rise in the number of cases of tuberculosis
notified and in the number of deaths recorded as being due to the disease.
This is similar to what is occurring throughout the country as a whole