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Constant vigilance is the main barrier which prevents this serious and
highly infectious disease from becoming endemic in this country. 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 last few years the growth of foreign travel has been associated
with a number of travellers being infected abroad. Consequently,
notifications have tended to increase during the "sixties" although the
actual number fluctuates widely from year to year.
During 1967 one case of typhoid was notified. This lady came to this
country on holiday from the continent and became ill the next day. All
visitors to the household were contacted and, after observation, found to
be free from infection.
Whilst immunisation against enteric fevers is undoubtedly a very
valuable procedure, the protection conferred is not of a high order and,
consequently, if the infection is heavy or its virulence high, inoculated
persons may contract the disease. When these diseases do occur in previously
immunised people the severity does not appear to be diminished.
Further disadvantages are that an ideal course consists of three doses
spread over six month and, that for continued protection, a booster is
required every 12 months.
DYSENTERY AND FOOD POISONING
Thirty cases of dysentery or food poisoning were notified during 1967.
Although this demonstrates an increase over 1966 when there were only
22 persons infected, the figures for 1967 are in keeping with the overall
reduction in incidence which has been noted since 1961. Nevertheless,
whilst this is a gratifying trend, it is far too early for any relaxation of
effort. Control of these diseases lies in the hands of the public themselves
in that all that is required are simple routine hygiene measures.
All cases are followed up by the Department to try to trace the source
of infection.