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65
ENCEPHALITIS
This condition might occur primarily, but more often occurs as
a complication to a number of infections such as measles, mumps and
chicken pox. During the year one notification of the post-infective
condition was received, that of a boy of seven whose encephalitis was
secondary to mumps. A primary notification was received of a woman
of 41 in June, and in another woman of 65 in July.
ACUTE ANTERIOR POLIOMYELITIS
Poliomyelitis in the country as a whole in 1956 ran in the earlier
months of the summer at a slightly higher level month by month than in
the previous year. There was a disturbing rise in the number of notifications
in the week ending June 2nd and a similar number of cases in the
next week, but that was followed by a week with fewer cases. In the main,
1956 proved to be a year of relatively low incidence, some compensation
perhaps for the appalling weather in the summer months. The actual
number of cases was 3,900, an attack rate per thousand population of 0-66.
Local incidence was light. There were two cases in January, the
end of the higher incidence of the previous year. Although a number
of patients were admitted to hospital on a provisional diagnosis of
poliomyelitis, it was not until July that the first case of the year's local
cases was confirmed. These were two sisters who came to the district
for a holiday, one of them being ill for the previous two weeks. It was
not until September that the first case contracted locally or at least
while living locally fell ill. Of the four cases with onsets in September,
two probably contracted the infection outside the district, one outside
the country and in the other case the diagnosis was very doubtful. In a
number of patients admitted to hospital suspected to be suffering from
poliomyelitis, a diagnosis of aseptic meningitis was made. Clinically
there is nothing to distinguish the signs and symptoms of this complaint
from that of the illness of a person who might later enter the paralytic
phase of poliomyelitis. Even the evidence of lumbar puncture may be
inconclusive and virus isolation is not always practicable. The sex
distribution of these cases is different from that of cases of poliomyelitis;
in general, in those up to fifteen years of age there is a greater liability
of males to poliomyelitis, this being more marked in the non-paralytic
than in the paralytic type of illness; over the age of fifteen, cases are
commoner in females. The absence of paralytic cases or an equal
incidences of paralysis in both sexes might suggest a diagnosis other than
poliomyelitis; so too would a marked familial incidence or the appearance
of clinical cases in several close contacts as these are not common in
Poliomyelitis.
There were two confirmed cases in October, three in November and
two in December. This persistence of cases to the end of the year was
in keeping with the general experience in the country in which, contrary
to what used to be the pattern when there would be a marked fall in the
level of incidence, the fall was slight and more or less regular.
Of the fourteen cases, seven were paralytic and seven non-paralytic.
five of the cases, three of them paralytic, were amongst males, nine