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86
DIPHTHERIA
Incidence
In none of the patients thought to be suffering from diphtheria was
the diagnosis confirmed. The district has now been free from the disease
since 1950, a period of eight years. The last fatal case was in 1946.
The number of cases notified in the country as a whole fell in 1957 to
a new low level record of 37 cases, of which 6 proved fatal.
Immunisation
The change in the material used at the clinics for inoculating children
against diphtheria, a change brought about because of the greater risk of
some preparations causing provocation poliomyelitis, has resulted in a
fall of the number of children inoculated against diphtheria. It is hoped
that the campaign for inoculation against poliomyelitis will soon result
in such a decline in incidence that it will be possible to revert to the use
of the combined prophylactics against diphtheria and whooping cough
which were becoming so generally accepted by mothers. Failing this,
perhaps infants can be given their protection against poliomyelitis
sufficiently early to allow the use of the combined preparation to those
who have had two doses of the anti-poliomyelitis vaccine.
During the year 1934 children were treated for the first time, 1,128 by
general practitioners and 806 at the infant welfare centres. The corresponding
figures in 1957 were 2,136, 1,174 and 962, and in 1956 2,336,
1,109 and 1,227.
The number of births notified during the year was 2,910. The aim
should be that during any year as many children should be treated for the
first time against diphtheria as the number of births.
It is estimated that at the end of the year 60 per cent of children
under five years of age were protected and 96 per cent of children aged
five to fifteen years.
Booster doses were given to 901 children, 491 by general practitioners
and 410 at the clinics.
SCARLET FEVER
134 cases of scarlet fever were notified in 1958. The rate per thousand
population was 0.62. The corresponding rate for the country as a whole
was 0.86. Although the number of notifications was nearly double that
of the previous year, the incidence of the infection was almost the lowest
experienced in this district. On only two previous occasions, including
1957 had there been fewer cases. The incidence of scarlet fever is subject
to violent fluctuation, the number of cases in this district in any one year
being as low as 76 in 1957 and as high as 707 in 1943. These variations
occur not on a smooth wave but quite spasmodically and without
apparent cause, and are the result presumably of changes in the organism
which causes the infection. There is a preventive against scarlet fever;
but with today's mild type of illness, it is not worth while its being used
for the protection of the general public, though possibly worth while to
protect those who are subject to a special risk of contracting the intection.