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57
Sixty-four visits in connection with Diphtheria were paid by
the Medical Staff.
No use was made of the Schick test (for susceptibility to
Diphtheria) nor of immunisation.
Sir George Newman, Chief Medical Officer to the Ministry of
Health, has stated that ' 'no Local Authority responsible for the
health of children should be satisfied that it has done its duty until
every parent knows that children can be protected against Diphtheria
with safety and reasonable certainty of complete protection."
The adoption of a comprehensive scheme of immunisation should
be carried out as soon as possible. The cost of testing and immunising
each child can be put at approximately 5s. for the cost of
materials.
Antitoxin is available for free issue to local medical practitioners
at the Public Health Offices; at the Fire Station and at
10, The Avenue, Highams Park. During 1931 a total of 173 phials
representing a total of 1,096.000 units were issued.
(D) ENTERIC FEVER.
Thirty-eight cases of Enteric Fever were notified during the
year—37 being Paratyphoid B.
The first case, in which full information as to its variety was
not available, was probably infected outside the Borough. The
series—Case 2 (notified on 6th February) to Case 34 (notified on
13th March), i.e., 33 in all—represented the local portion of the
great ' 'Epping'' outbreak, although in three of these the milk
supply appeared to be unconnected.
Investigation of Cases 2 and 3 (notified 9th February) showed
that milk was obtained from the same dealer, and inquiries were at
once made as to his sources of supply, and when these proved to be
from Epping Rural District it was apparent that a milk-borne
epidemic was imminent. This information was immediately sent
to the Ministry of Health and the County and District Medical
Officers of Health concerned.
All milk purveyors in the Borough were immediately circularised
advising the pasteurisation of all milk from Epping and
neighbourhood, or, if this were not possible, asking them to instruct
their customers to boil all milk before use. All medical practitioners
were the same day circularised drawing their attention to the
prevalence of Para-typhoid Fever in the Borough and requesting
early notification.
By the 11th February all available beds in the Connaught
Hospital had been filled, and arrangements were made with the