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cases, some in Essex and some in Hertfordshire. Later, some towns were
especially attacked. The curve of incidence flattened out, though, and the
peak figure of 367 was reached in the week ended August 27th. From
then the fall was rapid for a few weeks, so that by the week ended
October 12th fewer than 100 cases were notified in a week. The total
number of cases notified was 3,440, a rate per thousand population of
0.08. The figure for 1955, a year of light incidence, was 3,900; that for
1947, a year of greatest attack, was 7,305.
The usual curve of incidence is a rise to a maximum about September,
followed by a fall to a minimum in March. This means that many of the
notifications in any one year are of cases which are the fading out of the
previous year's increased prevalence. This has meant that in this district
there have usually been one or two notifications in January or February
not related to the higher incidence later in the year. This year, however,
there were no such cases and this district escaped until the first week in
June when there was one case. Then followed two clear weeks, followed
by three each with a single case. The numbers of notifications in the
succeeding weeks were 0, 1, 1,0 and 1, so that by the week ended
August 10th there had been only seven cases; in the next week, though,
there were seven cases and in the succeeding weeks 3, 3, 2, 3, 2, 1 and 1,
the last case being in the week ended October 5th.
Of the 29 cases, 14 were paralytic and 15 non-paralytic. The first
paralytic case did not occur until the week ended August 10th, being the
seventh case notified. In the series of eight cases from the week ended
August 24th to the week ended September 9th, six were paralytic cases.
The sexes were nearly equally affected, 15 male and 14 female, the
14 paralytic cases being distributed 8 and 6. Four of the notified cases
(three of which were paralytic) were in children under 5 years of age,
seven (three paralytic) children between 5 and 10, six (three paralytic)
in children 10 to 15. Only two adolescents were affected, both with
non-paralytic attacks. Of the ten male adults affected, five had paralytic
attacks.
It was at one time quite exceptional for more than one case to occur
in a family. It is now, however, not an uncommon event and there were
two such instances. The first was when what proved to be a paralytic
attack in the mother was followed after an interval of seven days by her
boy of 7 having a non-paralytic attack; the diagnosis in the mother was
not made until the boy was ill, both patients being removed to hospital
together. The other instance was one of simultaneous onset in a father
and his girl of 7 years of age, both non-paralytic attacks.
Inoculation against Poliomyelitis. Although it had been expected
that supplies of vaccine would be available from the beginning of the year,
it was not until the middle of March that the first supplies of that year
came to hand. The Minister had decided in 1956 that the arrangements
for vaccinating children against poliomyelitis should be discontinued in
the months when poliomyelitis might be expected to be particularly
prevalent. There was no corresponding decision in 1957, and as there
was no period of sufficiently high prevalence to raise the question of
temporarily discontinuing the practice, inoculations were carried on
throughout the year as vaccine became available.