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55
then on there was almost week by week a slight fall. By contrast with
other years though, there was no sudden drop in the late autumn. In
fact there was as many as 259 notifications in the first week in November
and it was not until the middle of December that the weekly notification
figures fell to below 100.
Locally the incidence was light to start with. There were no
notifications at all until the first week in July. The weekly figures from
then onwards were 2, 0, 2, 2, 1, 0, 3, 2, 3, 0, 1,4, 1, 1, and 2 in the week
ending October, 22nd. Then at the period when it is usual for the
incidence to fall, the attack rate in this district rose. In the week ending
October 29th there were five notifications. In the succeeding weeks
there were 3, 1 and 5 and then one in every week for the rest of the year,
except that the week ending December, 24th was free. Of the notifications
25 related to paralytic and 19 to non-paralytic cases. There were 4
fatalities.
The cases occurred in all parts of the district and none seemed to
be associated with any other. There was no suggestion of school
attendance or attendance at a nursery school having played any part in
the transmission of the infection.
Although it was not until 1947 that this country was attacked by a
nation wide outbreak of poliomyelitis, other countries had already
suffered devastating attacks. The incidence in the United States has
for long been uniformly high. This would be an added reason for this
country paying so much attention to efforts to prevent the complaint,
endeavours which go back many years. By 1935 they had a vaccine
which it was hoped would afford protection. Unfortunately, however, the
use of the vaccine resulted in disaster and its further use was forbidden.
Work continued to be carried out. Vaccines can be divided into the
groups of the living though modified, or attenuated organisms, the other
dead organisms or material from organisms. The latter type has the
advantage of safety and it is on this type that most work has been done.
Salk in America made a pure-culture vaccine, killed by formalin, which
was free from the dangers of the older preparation. American experiments
showed that it was safe and because it gave rise to the formation of the
same protective substances as are found in those who have withstood a
natural attack of the disease, it was considered that it would afford
protection. Controlled trials in the United States and in other countries
showed that the vaccine was 80 to 90 per cent. effective in preventing
paralytic poliomyelitis amongst children. The National Foundation
for Infantile Paralysis made sufficient vaccine available to inoculate
nine million school children, the actual manufacture being carried out
by a number of firms. The trial started in the early part of 1955.
Unfortunately the use of the vaccine prepared at one laboratory was
followed by inoculation paralysis in a number of those treated. It had
been intended that a trial of the Salk vaccine should have been made in
this country in 1955. In view of this occurrence in America this trial was
cancelled.
While it can be accepted that the vaccine will afford protection,
nothing as yet is known of the duration of its effect, and it might be
found that it will be necessary for repeated inoculations to be given if