View report page

80
Inspector of a local authority that the cleansing, purifying or destruction
of any articles under Section 84 of the Public Health Act, 1936 (Cleansing
or destruction of filthy or verminous articles) is urgently required, he may,
subject to any direction of the local authority, himself cause such articles
to be cleansed, purified, disinfected or destroyed at the expense of the
local authority and, if necessary, be removed from the premises.
The Public Health Committee at their February meeting " authorised
the Medical Officer of Health to carry out the cleansing etc. of articles
mentioned pursuant to Section 42 of the Middlesex County Council Act,
1956, and to report any action taken to the next ordinary meeting of the
Committee for confirmation."
DIPHTHERIA
Incidence
In none of the patients thought to be suffering from diphtheria was
the diagnosis confirmed. The district has therefore now been free from
diphtheria for seven years; the last fatal case in this district was 1946.
There were in the whole country in 1956 only 56 cases, with eight deaths.
This was the first year when notifications were fewer than 100.
Immunisation
The fall in the incidence of the disease must largely be attributed to
the practice of immunisation. While the fact that there are only small
numbers of cases in the whole country at any one time means that the
likelihood of any child being infected is reduced, the position still remains
that the child who has not been protected is liable to contract the disease
on exposure to infection, and that infection is not necessarily from a
recognised case of illness. As there are so few cases, many parents have
not had any knowledge of the disease; this, unfortunately, leads to the
risk of some parents becoming too complacent. With the growing number
of diseases against which protection can be given by inoculation, some
might start weighing one against the other. The likelihood of this is
lessened when it is possible to give protection against more than one
infection by the same series of inoculations, and it is possible that many
children were being protected against diphtheria because the same preparation
was used to protect them against both whooping cough and
diphtheria. This combination was particularly fortunate, as the presence
of the second antigen in the mixture enhanced the effect of the first, with
the result that, because whooping cough antigen was present, the diphtheria
component was more effective than if it had been given alone; and the
same enhancing of the effect of the whooping cough antigen was brought
about by the presence of the diphtheria component. However, when
tetanus toxoid was added, giving a mixture of all three antigens, this
seemed to lead to some reduction in the effect of the other two components.
No doubt this is something which can be got over, and there are hopes
that a preparation will be available which will protect against the four
diseases—diphtheria, whooping cough, tetanus and poliomyelitis. But
there would still be the question of the timing of the doses because, while
it is desirable that protection against whooping cough should be given to