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9
Consideration of the infectious diseases notified during the year shows
a relatively satisfactory position with reductions in several of the more
common infections. As expected in the year following an epidemic one, the
incidence of measles was low. Normally one would expect the incidence to
rise again in 1969, but in view of the fact that vaccination against measles
was introduced during the year it will be interesting to see the effect this
will have on the figures for 1969. Mention was made last year of the special
investigation survey carried out in conjunction with the Central Public
Health Laboratory to identify the serotypes responsible for cases of
whooping cough (which appear to be on the increase). Changes in the
antigenic structure of the epidemic strain organism were thought to be the
probable cause of the rise in incidence, but in order to make quite sure,
it was decided that further research was necessary and this will begin in
1969. During the year there was a slight increase in the number of cases of
dysentery mainly affecting children, which lead one to stress once again
that a high standard of hygiene is of paramount importance in controlling
this disease. There was only one case of enteric fever during the year and
this was acquired abroad. The only death due to infectious disease was
caused by tuberculosis.
In the Clean Air programme two further Smoke Control Orders
became operative during the year and three further Orders were confirmed
by the Ministry of Housing and Local Government to come into operation
during 1969.
With regard to the fluoridation of water supplies the Minister of
Health in circular 24/68 removed altogether the time limit on the indemnity
against proceedings on the grounds of injury to health. This has had no
effect locally as although the Council has adopted a recommendation that
arrangements be made for the addition of fluoride to the water supplies of
the Borough, no further action can be taken until such time as there is
unanimity among the various local authorities within the water undertakers'
statutory area of supply.
A Health and Social Service Department is never static—the more
services provided, the more the demand. Cognizance must also be taken
of changing patterns in the various services and arrangements made to
meet these changes. As a result there must be a continuing brief in the
Department preparing for increased demands, anticipating changing
patterns and above all trying to improve service to the public in general.
During the year expansion in the chiropody, home help, health visiting
and welfare services necessitated increases in the establishment, while on
the other hand due to changing patterns, modifications were made in the
domiciliary nursing and midwifery services—fuller details of which are
incorporated in the main report.
No major changes were introduced into the school health services
during the year as the routine measures of inspecting and advising already
set up as standard procedures in past years still work very well. As