View report page

118
to develop, will come into play by the time the infant is losing his natural
immunity and is reaching the stage when he is more likely to come into
contact with infection.
Many children are treated by general practitioners at the same
time against diphtheria and against pertussis. The antigen in this case
is not provided free of cost. Large numbers of children who attend the
infant welfare clinic receive their immunising doses there. In most cases
the mothers are anxious for the children to be protected at the same
time against pertussis so in these cases the combined preparation is used.
Most children attending the day nurseries have already been protected
before admission. Facilities are available though for immunising those
who have not been treated.
During the year 2,387 children were treated for the first time, 1,148
by general medical practitioners, and 1,239 at infant welfare centres.
The number of births notified during the year was 2,747. It is estimated
that at the end of the year 64 per cent. of children under five years were
protected and 87 per cent. of children aged 5 to 15 years.
SCARLET FEVER
Incidence
Scarlet fever is a disease which is always present to some extent in a
district of any size. Typically it is more common in the autumn. It
attacks children more than adults. Twenty per cent. of the population
suffers from this illness some time during their lives. Few suffer from
more than one attack, though the proportion of second attacks of scarlet
fever is higher than for instance of measles. In some years the disease
is very much more prevalent than others, though the added prevalence
is not necessarily associated with increased virulence. Local rates of
incidence since 1934 have ranged from 1.06 to 4.7 per thousand population,
the greatest number of cases being the 707 of the year 1943.
The incidence locally and throughout the county in 1954 was light.
The 209 local cases were an incidence rate of 0.95 per thousand population
compared with the national rate of 0.98.
The infection was slightly more prevalent in the first quarter of
the year when there was an average of six cases per week; in the next
quarter the weekly incidence rate was 3.5; there was a slight fall to 3 0
in the third quarter and back to 3.5 in the last quarter. There was no
autumnal rise. The period of lightest incidence was from 21st August
to 25th September, when only five cases were notified.
Deaths
There have been no deaths from scarlet fever in this district lot
many years. For the country as a whole the case mortality is a fraction
of one per cent. This is in marked contrast to the position at the end
of the last century when scarlet fever had a case mortality of sixteen per
cent. In parts of Europe just before the war the infection was of this
severe nature. There have been localised outbreaks of virulent infection
since the general type became mild. There can then be no feeling of