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In addition, recent regulations provide that travellers from countries
where smallpox is endemic must have been vaccinated recently, otherwise
the local authority is responsible for keeping such travellers under
surveillance for three weeks after their arrival in this country. 22 residents
of Harrow were kept under surveillance during the year.
Vaccination of infants is a very valuable defence, but as the protection
conferred only lasts a few years its value can only be regarded as secondary
to that of constant vigilance.
Primary vaccination can, and often does, give rise to local and
constitutional disturbances such as pain and swelling of the arm accompanied
by fever and headache. As travellers often have to leave at short
notice their malaise tends to occur at the moment of departure. Vaccination
for the second and subsequent occasions is usually without such side
effects. An additional reason for recommending vaccination during
infancy is that, as with all medical procedures, slight risks are involved.
These risks are almost solely associated with primary vaccinations and the
chances of complications occurring are increased with older patients.
ENTERIC FEVER
During the four year period 1934-1937, 19 cases of enteric fever were
notified. During the three quadrennia 1938-1949, there were great
movements of service personnel and the notifications were 34, 14 and 29
respectively. The return of normal peacetime conditions during 1950-1957
led to four year returns of 19 and 14 respectively. A considerable reduction
of cases during the latter period 1954-1957 were masked by the
notification of 8 cases in 1955.
Satisfactory progress was made during 1958-1961 when only three
notifications were received. However, the period 1962-1965 showed an
increase of 12 cases and this trend continued in 1966 when 11 tourists
acquired infection overseas. This rise is coincidental with the increased
foreign travel undertaken by all nationalities and serves to indicate that in
future years continued vigilance will be required if a return to the high
figures prevalent during the war years is to be prevented. However,
considering the total population movement the individual risk is slight.
There was one case of typhoid notified in the Borough. This lady had
just returned from a coach tour of Italy and contracted the infection
abroad. All other passengers were traced and their local Medical Officers
of Health reported them free from infection.
There were 10 cases of paratyphoid amongst a party of local schoolgirls
who had visited Paris. Although the source of the infection was never
identified, it is certain that the infection was contracted in Paris, as
other parties were also infected. This particular outbreak was characterised