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raised by the two inoculations fell; on the other hand, it could be raised
again by a booster dose. It is probable that it was similar experience in
America which led them to decide that a course of inoculations should
be two doses spaced at three to five weeks, followed in some nine months
by another dose; what happens after that is not known. It may be that
the actual level of anti-body is not the important point, but that the effect
of the inoculation of the dead vaccine will result, on the exposure to
infection, in an immediate increase in the state of immunity.
Although there is as yet no question of the use of an attenuated live
vaccine being given orally, preliminary trials did not point to any harmful
effects, either on the persons vaccinated or upon members of their families.
It is hoped that such a vaccine can bring about a lasting immunity and
result in the elimination of virulent strains of virus at present in circulation,
something that the present killed vaccine is not able to bring about.
During the year 13,756 doses of vaccine were received. The number
of persons known to have received two injections during the year was
5,147. A further 1,397 received one injection.
MEASLES
1957 was not a year of heavy incidence of measles, in all only 1,783
being notified. Starting with a weekly average of only eight in January,
the number of notifications rose to its height in April with a weekly
average of 80. A fall then set in, but the upward trend was resumed in
July when the weekly average reached 66. In August there was a further
decline, and for the rest of the year there were only occasional notifications.
Although the attack rate of schools varied and some were affected in
the spring term while others which had escaped then were involved in the
summer term, the disease appeared in schools throughout the entire district.
Clinically the illness remains of the mild variety, only four patients
suffering from it having to be admitted to hospital. There were again no
deaths from measles. The fall in the fatality rate from 0.03 in 1955 to
0.02 deaths per 100 notifications in 1956 for the country as a whole
suggests that measles is losing its killing power.
WHOOPING COUGH
256 cases of whooping cough were notified. Most of them occurred
in the first five months of the year when in many weeks as many as ten
cases were notified, but in only two weeks were there more than 20. The
weekly average of notifications for this period was 11. In the next three
months the average weekly notifications were just over two, and in the
last four months there were in all only nine cases.
No sufferers were removed to hospital, and once more the infection
caused no deaths amongst those in this district.
It is accepted that to-day's vaccine against whooping cough is most
useful. So far from it being claimed that it affords full protection in all
cases, it is accepted it does not do so. On the other hand, it does seem
that those who have been treated but who nevertheless contract the
infection suffer from only a mild attack, so vaccination does much to
remove the danger and also much of the distress of this complaint. That
full protection might not be afforded has the disadvantage that an atypical