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43.
The material used for immunisation is alum precipitated
toxoid. Schick Testing is carried out at 3 months and 2
years approximately after immunisation, Further reference
to this subject will be found in the report of the School
Medical Officer.
Close attention is given to the following up of contacts
of cases of Enteric Fever. In one instance in 1943, the
patient was not a Kingston resident but visited Kingston for
the purpose of attending a wedding a few days before the onset
of the disease.
Enquiries were set on foot immediately and it was ascertained
that there were about 50 persons present at the
wedding. Difficulties were encountered in that it was not
possible to obtain a complete list of the guests immediately,
with the results that many visits had to be made to the persons
in the district and enquiries made of Medical Officers of
Health in the neighbouring Authorities to check up everyone
who was present. Every family represented at the wedding was
interviewed and many communications were written regarding the
case and contacts.
No further cases occurred in relation to this patient
which was satisfactory after the amount of following up which
was undertaken.
Another case, in respect of which detailed investigations
were necessary, occurred in 1942. This case was notified in
another district, but the patient had stayed in a common lodging
house in Kingston-upon-Thomes up to the date of the onset of
the illness. The lodging house was visited the same day and
all the occupants were interviewed. In certain cases, arrangements
were made for bacteriological examinations, all of which
proved negative, The keeper of the lodging house undertook nc
to accept new lodgers for a specified period, and daily visits
were made, mostly at night, in regard to The state of health
of all the occupants. No further cases arose in relation to
this patient.
The incidence of enteric fever (including paratyphoid
fever) v/as low generally during the period under review, and
in no case was the source of infection definitely established.
The highest notified in any one year was seven in 1941, . but
these cases occurred at intervals during the year, and there
was no indication of a common source of infection, despite
detailed investigation.
The following tables show in detail the numbers of cases
of notifiable infectious diseases notified during the past
five years: