London's Pulse: Medical Officer of Health reports 1848-1972

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Harrow 1955

[Report of the Medical Officer of Health for Harrow]

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56
the state of the immunity of the population is to be maintained. On
the other hand even the temporary protection of large numbers of the
susceptibles of the population might so lower the incidence of the infection
in the summer and autumn months that the lowered prevalence would
be followed by a period of absolute freedom from the disease in the winter;
that is to say, large scale inoculation might bring back this country to
the same state as it was in before 1947 when in the winter months there
were no cases at all. In that event perhaps the pattern of incidence
would revert to that of the years before 1947 in which at the most
localised outbreaks occurred. Against such a reduced risk there would
perhaps then not be the need to carry on with the protective measures.
MEASLES
Measles is an infection which characteristically in an urban
community has a biennial beat. Cases build up towards the end of one
year to reach a peak in the early months of the next year. From this high
level maintained for a few weeks, notifications fall to virtual extinction
in the early part, or the middle, of the summer. From then on the
district is relatively free until the building up again towards the end of
the next year. Although there is this long period of freedom from
infection, this does not come out clearly in the figures of notifications,
though usually the larger figures of one year contrast sharply with the
smaller figures of the succeeding year. In point of fact this district has
not yet acquired this typical pattern of distribution. 1954 was a year
of very light incidence so that it could be expected that the district would
be invaded in 1955. But the latter part of 1954 showed none of the
building-up of the cases which are the usual prelude to an attack in
the next year, and in fact conditions were quiet throughout January when
in all there were only 34 cases. The incidence rose though in February,
but more speedily in March, in the last week there being 210 notifications.
There was the same number in the next week, but the highest number
was the 249 in the week ending April, 16th this being the greatest number
of notifications of measles in this district ever received. A sharp fall
to the middle of May suggested the outbreak was over; but there was
another rise to the end of the month. The same pattern was followed
again, cases falling to a low level in the middle of June, but rising to 165
notifications in the week ending July, 16th. From then the fall continued
to the extinction of the disease, but there was some smouldering again
of cases in the autumn. Altogether the distribution throughout the
district in this year was most atypical. The figures for the country as
a whole were much the same—a peak in early April, a second peak a
fortnight later, a fall and then a smaller peak at the end of June. In
all 3,124 cases were notified.
Measles now is not the dread disease it was not so long ago, Not
only does it seem to be more mild in itself, but therapeutic agents are
available to deal with those complications vyhich do arise, complication
which at one time caused so much trouble. The fact that only three
sufferers were removed to hospital is an indication of its more benign
character, and also that there were no deaths from the complaint.
There is no agent which can be used to bring about an active
immunity and so protect a child from an attack from which most sutfer at