View report page

78
experienced one of the hottest and sunniest of summers for years, one in
which in ordinary circumstances it could have been anticipated that there
would have been many cases of poliomyelitis, in point of fact its prevalence
was low. For this active immunisation must be given much of the credit.
There was no change during the year in the arrangements made to
control the spread of the various infections.
During the year, authority was given for steps to be taken for the erection
of the new disinfecting plant.
DIPHTHERIA
Incidence
Although a number of patients were suspected to be suffering from
diphtheria, in none was the diagnosis confirmed. The district has been free
from this infection since 1950, a period of nine years. The last fatal case
was in 1946.
In this last year there have been outbreaks of diphtheria in different
parts of the country with the result that the curve of incidence which had
fallen each year since the practice of immunisation of children against
diphtheria was accepted on a wide scale throughout the country in the
early 1940's has not only continued to fall, but has risen sharply. What
has happened in these different districts is a sharp reminder that diphtheria
was controlled only by large scale immunisation, and can be held in check
only by the same means.
Immunisation
An undue proportion of cases of paralytic poliomyelitis were found
to occur in children who had recently been inoculated. Enquiries showed
that the risk was greater following some inoculations than others, and
that there was a variation in the risk of antigens used to protect against
the one infection. There have been few cases of these, but because there
was a different incidence after varying preparations, it was decided that
the use of those which semed to carry the greater risk, even though this
was quite slight, should be discontinued. For this reason the use of the
combined preparation aimed at preventing diphtheria and whooping
cough was discontinued. This meant the children who were to be protected
against both these infections had to receive a greater number of inoculations.
This is the probable explanation for the fall in the numbers of
children being inoculated against diphtheria. In the Spring a conference
of those specially concerned with the matter was held. It was hoped
the outcome would be a firm recommendation about the practice ot
immunisation against the various infections, so that the arrangements
would virtually become standard throughout the country. It was, however,
not possible to reach agreement as some were still much concerned about
this risk of provocation poliomyelitis. Most have concluded that the
risks were magnified, and in any case that what risk there was had to be
set against the fact that the price of reducing this risk was that many more
children, because they were not being immunised against diphtheria,