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the disease. Unfortunately though the incidence of reactions associated
with the inoculation was high. Most recovered in a few days; some
though developed serious complications, mostly infections of the middle
ear and respiratory tract. It would seem that the present vaccine is
effective, though the duration of the immunity conferred is not known.
The complications which it might cause though make it doubtful whether
extensive trials are justified, and research towards further attenuation of
the vaccine virus is desirable.
WHOOPING COUGH
The district was almost entirely free from whooping cough throughout
1961, only fifty-nine cases being notified. These were spread throughout
the year, but the incidence was rather more common in the first half.
Whooping cough is an infection with no set pattern of periodicity. The
relative freedom might be wholly due to changes in the infectiousness of
the organism. On the other hand, so many children are now being inoculated
against whooping cough that this must have quite a substantial
effect on its prevalence. If any child who develops pertussis is surrounded
by those who are immune, passage to others is barred. In the earlier days
of inoculation against whooping cough the preparation was a long way
from being fully effective. The result was that some of those incoculated
on exposure might contract the infection, but as they were partially
protected the attack would be atypical and so very often the characteristic
whoop would not develop. The attack then might not be recognised for
what it was, so that infection would be passed on to others, possibly more
than would have been the case if the child had not been inoculated and
had developed a frank and recognisable attack. This is less likely to occur
today with the more potent vaccine. Whooping cough is still a killing
disease in young children, especially those under one year of age and more
especially those under six months. This emphasizes the need for those who
are to be protected to have their inoculations in infancy. On the other hand,
the infant is introduced to the infection generally by the development of
the disease in an older child of the family. If all these older children are
adequately protected, there is that much less risk of the infant being
exposed to infection while at an age when the attack is most damaging.
Were inoculations against pertussis generally practiced amongst all
children, there would be the less need for the infant to be protected while
very young. It would too reduce the disadvantages following on the
development of an atypical attack in a child whose inoculation had afforded
only partial protection.
No persons suffering from whooping cough were removed to hospital
and this infection caused no fatal cases in this district in 1961.
Inoculation. During the year, 3,111 children were inoculated
against whooping cough, 2,034 by general medical practitioners, and
1,077 at the clinics.