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THE WORK OF THE DEPARTMENT
CONTROL OF COMMUNICABLE DISEASE
Dr. Geoffrey Poole, Deputy Medical Officer of Health, writes:—
That perennial pestilence, Sonne Dysentery struck early this year, the first case (an
18 month-old toddler attending a Day Nursery) being notified on January 4th. Immediate
investigation revealed that other children in the nursery were carrying the germ and eventually
40 children and 4 nurses had to be excluded. Family contacts spread the disease in the northern
part of the Borough and twelve schools (one private) and another nursery became involved with
a total of 224 families affected necessitating over 1,000 home visits. Through the ready cooperation
of parents, teachers and family doctors the outbreak was contained, no spread to the
rest of the Borough occurred nor were there any other large-scale outbreaks. As forecast in
last year's report it has now been generally recognised that antibiotics have little effect in
this disease and are worse than useless in the convalescent or symptomless case where they
tend to prolong the carrier state. Stringent hygienic precautions and the control of carriers
offer the only means of preventing the spread of diseases of this type against which even the
latest wonder drugs are impotent.
Measles was again the commonest notifiable disease with 1,558 cases compared with
(308) last year and this might suggest that vaccination against this disease had not proved
effective. But this year's figures should really be compared with the 2,615 cases notified in
1967 since the biennial epidemic pattern, though modified by vaccination, persists to some
extent. Futhermore this year's vaccination programme was seriously disrupted when the whole
of one manufacturer's stock of vaccine was recalled following the occurrence of some adverse
reactions. Measles is a miserable and dangerous disease which sometimes leaves permanent
damage to the brain and special senses and, now that vaccine supplies are again adequate,
should be prevented wherever possible.
Whooping-cough with only 30 notifications (126) showed a welcome reduction due to the
development of more effective vaccines following the recent Medical Research Council investigation
into the currently prevalent strains of the causative organism. Scarlet Fever was up,
but not significantly at 102 cases (79) but there was a marked increase in Food Poisoning with
33 notifications against only (4) last year. In this condition the notified cases are well known
to be only the tip of the iceberg as the vast majority of people suffering mild transient attacks
do not call their doctor. There is no reason to suppose, as these figures might suggest, that
Food Poisoning has increased eightfold. But even a single caseof Food Poisoning is one too
many and it is our constant endeavour by inspection, enforcement of Food Hygiene Regulations,
and by Health Education to prevent this eminently preventable disease. Infective jaundice too,
showed an increase to 31 cases (9) and all were investigated to exclude the possibility of
syringe-transmitted jaundice from self-injection of drugs. A small outbreak of meningitis,
fortunately of a mild type, occured but no common source could be found.
Potentially the most dangerous epidemiological event was the occurrence in August of
Typhoid Fever in a very severe form in a Walthamstow lady who had not been abroad and must
have been infected locally. The source of her infection was never traced despite the most
urgent and painstaking investigation in which great assistance was given by Dr. B.T. Thorn, the
Director of the Public Health Laboratory at Whipps Cross. No secondary case occurred and the
prompt and efficient action by all concerned prevented what might have become a serious epidemic.
Another possible source of danger arose as a result of the strike by the refuse collectors
involving almost the whole of Greater London. Rodent control in this Borough being excellent
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