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the infection, vaccination of the susceptibles is a very powerful weapon
and particularly with some populations the extent to which this is done
depends on the ease with which vaccination can be done. There are hopes
that the recently prepared freeze-dried vaccine which retains its potency
at ordinary temperatures longer than the usual preparation might result
in smallpox abroad being more readily controlled, with resulting benefit
to those in this country.
ENTERIC FEVER
Of the five patients who were notified to be suffering from typhoid
fever, one was a carrier and in two the diagnosis was not confirmed. Of
the other two, one was a person who lived out of the district and the
notification of paratyphoid fever was made to the local authority here
only because the patient at the time of diagnosis was in a hospital in this
district. The remaining case was that of a girl of 11 who would seem
to have contracted her infection of typhoid fever because of her fondness
for cockles. She fell ill while at home on the 23rd August. She had,
however, spent her holidays from the 4th to the 15th August at a seaside
resort where she consumed quantities of cockles.
DYSENTERY
The numbers of notifications of dysentery probably do no more than
give an indication of the prevalence of this condition. It is not uncommon
when enquiries are being made about a case that has been notified for it
to be learned that other members of the family are suffering from a
similar condition, but have not been notified. On the other hand, in
some cases notified on clinical grounds, the diagnosis is not confirmed on
bacteriological examination.
This year 17 notifications were received. Five of them related to
children in a children's home who succumbed to a Sonne infection on the
same day. The notification that a man of 46 was suffering from Sonne
infection led to the recognition that infection had probably been introduced
into the house two weeks before by a boy of seven; at the time of the
visit the grandmother was suffering from diarrhoea and two persons who
had visited the week before had gastro-intestinal symptoms. The illness
in a girl of 11 due to a Sonne infection was followed four days later by
her sister and her mother being similarly attacked. Six of those notified
were the only members of the family to be affected; in none of these
did laboratory examination confirm the diagnosis.
When a dysenteric organism is recovered, it is almost invariably the
Sonne variety. This year an adult woman suffered from an attack
to a Flexner organism. She probably contracted the infection from her
boy of seven who had been admitted to hospital the previous week with
gastro-intestinal symptoms.
11 of the notifications were received in March. Of the others,
the onset of one was in April, the next in June, and the remainder one in
each month from September.
At one time a disease introduced by food, dysentery as now seen in
this country has changed its pattern, being brought in more by personal