View report page

WORK OF THE DEPARTMENT
Control of Infectious Disease
The aphorism "the Price of Freedom is Eternal Vigilance" was never more apt than when
it is applied to this branch of public health. During 1965 the Deputy Medical Officer of Health
and/or the Infectious Diseases Nurse made over 1,500 home visits concerned with the diagnostic
or control of infectious diseases.
The current vogue for Continental holidays and the continuous influx of immigrants from
Africa and Asia (and from other regions with relatively low standards of hygiene and a high
incidence of infectious disease) has made it necessary, if we are not to slip back 50 years in the
progress of public health and hygiene, to trace and keep under surveillance during the incubation
period all travellers who have been exposed to contact with the diseases like typhoid or smallpox,
now virtually eliminated from this country but still common abroad.
Britain's insular position itself once served as a cordon sanitaire; voyages from the
Orient taking several weeks so that a passenger incubating one of the exotic infectious diseases
developed symptoms while still at sea. Such infected ships were forbidden to berth alongside,
and had to lie at anchor until the Port Medical Officer had examined and cleared or quarantined
all contacts. With the growing development of speedier travel, especially by air, this protection
has been lost but attempts are made by Port and Airport health authorities to inform us of any
known contacts so that they can be placed under surveillance, and also, via the Ministry of Health,
to notify us of immigrants from areas where such infections are common and who have given
destination addresses in Waltham Forest. Of the latter 196 notifications were received, of which
132 were eventually found after a total of 329 visits. Almost 33 per cent proved untraceable,
having given accommodation addresses, changed their plans, or merely stayed a day or two before
moving to an unknown address. Lack of English, especially among Pakistanis, makes questioning
barren, and many are unable to read instruction cards printed in their own language. All immigrants
are advised to register with a general practitioner and to have a chest X-ray. Those from India
(38) and Pakistan (57) represent more than two-thirds of the total traced, and probably account for
the majority of the 64 who could not be found.
Immigrants of these races are usually adult males, frequently a dozen or more sharing a
house, but when a family is included additional information about local clinics, schools and other
municipal services affecting women and children, is given and the name and address passed to
the District Health Visitor for follow-up. These two races also are especially prone to respiratory
tuberculosis, the spread of which is facilitated by their habit of living in conditions which we
should regard as grossly over-crowded.
Details of the incidence of individual diseases, and the schedule of visits made by the
Infectious Diseases Nurse appear in the statistical portion of this report, but the following are
illustrative of the variety of work involved in Infectious Disease control during 1965.
1. ANTHRAX
Information was received from the Ministry of Health of the development of an effective
vaccine against this dangerous disease. Employees at two factories in the borough, one an
importer of hides and manufacturer of dressed skins and fur articles, the other a manufacturer of
bristle shaving brushes, are at risk and vaccination will be offered either through the general
practitioner service or by a doctor from the Health Department.
-7-