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12
Vaccination is our only real weapon against the inroads of smallpox.
The incidence of certain cases of encephalitis, following
vaccination in some cases, has caused some concern. Although the
cases have been extremely rare compared with the number of vaccinations
carried out, it is to be hoped that medical research will speedily
find a means by which they can be altogether avoided. In the meantime,
in August, 1929, the Ministry of Health, in accordance with
the report of the Committee on Vaccination, amended the Vaccination
Orders by which in lieu of 4 insertions of lymph, only one should be
made, and that multiple scarification should be avoided. The
occurrence of these cases of encephalitis emphasises the fact that
infancy is the time of choice for primary vaccination to be carried
out.
The outbreak of paratyphoid fever which occurred in 1928 did
not again occur in 1929.
Scarlet fever and diphtheria were again epidemic in the town.
The number of cases of scarlet fever showed some decrease on those in
the previous year.
There was a considerable increase, however, in the number of
cases of diphtheria. 123 cases occurred in houses in the L.C.C.
Housing Estate at Becontree. It will be noted that of the 305
cases which occurred in Ilford, 155 occurred in the G-oodmayes
Ward. The disease was of a severe type and it will be noted from
Table Ia that the provisional figures of the Registrar General show
that the annual death rate from diphtheria in Ilford was .14 compared
with .08 in the country generally. The attack rate from
diphtheria in 1928 was, for England and Wales, 1.55; Ilford, 2.0;
Dagenham, 3.16. The disease did not appear to be conveyed to
any extent by school attendance and the outbreak was probably
occasioned by the accumulation of a large number of susceptible
persons in the Becontree area and also an increase in the ' 'carrier''
rate. Such outbreaks have occurred in other new housing estates.
It is a question, however, whether the actual incidence of
diphtheria was greater in Becontree than it would have been in the
areas from which the families concerned were removed.
The only method of dealing with such a problem is to raise the
number of insusceptible persons in the area. At the request of the
London County Council a Carrier Clinic was established at Guys