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highest number of cases in any one year being the ninety-five of 1937.
The highest number of deaths was nine in 1939. For this, as for many
parts of the country, this once dangerous complaint with its high case
mortality is just a memory; but can remain so only if parents will have
their children inoculated not only in infancy but later, receiving booster
doses. If they see to their children being protected in this way, then
children lying in bed flat on their backs perhaps for weeks, children on
whom tracheotomy has been performed and children with bull necks in
whom the prognosis was so black too will remain a memory.
Immunisation. Antigen given to stimulate resistance to the disease
may be given by itself, in combination with pertussis antigen, or as a
component of triple antigen which aims at protecting against diphtheria,
whooping cough and tetanus. During the year, 3,254 were treated for the
first time, 2,142 be general practitioners and 1,112 at the infant welfare
clinics. The corresponding figures for 1960 were 3,055, 1,541 and 1,514. It
is estimated that at the end of the year, 69% of children under five years
of age were protected and 97% of those aged five to fifteen years. These
figures are probably sufficiently high to ensure freedom from the risk of
any serious outbreak of this infection in this district. While the larger
proportion of immunes helps to protect those not immunised, there is,
of course, no guarantee that those unprotected children shall not be
exposed to infection, and on such exposure, as they are not immune, they
are liable to contract the infection. The protection of any individual child
can be assured only by the development of immunity in that child, and
this for ordinary purposes means that that child must be inoculated
against the disease, and later inoculated again. Particularly these days
when children are not exposed to the organism and therefore do not
receive the subliminal infection necessary to maintain their state of
immunity for them to remain protected, it is necessary they have booster
doses of antigen. These are given at about five years of age when the child
is going to school and so is subject to a greater risk of exposure than he
has met up to then, and again at ten years of age. Booster doses were
given to 2,456 children, 1,861 by general practitioners, and 595 at the
clinics.
SCARLET FEVER
In this last year the district escaped heavy infection by scarlet fever.
102 cases were notified. In two the diagnosis was withdrawn. The net
figure of 100 is a rate per hundred thousand population of 0.47, compared
with the national figure of 1.1. Scarlet fever today continues to remain s
mild disease causing very few deaths. The last case contracted in this
district which proved fatal was in 1937.
Although mild, scarlet fever is still communicable. Its mildness is due
to the relative innocuousness of the causative organism and is not due a
all to human agencies. Just as for some reason it has become more
innocuous, so it can revert and become more toxic. There is no reason at