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THE WORK OF THE DEPARTMENT
CONTROL OF COMMUNICABLE DISEASE
Dr. Geoffrey Poole, Deputy Medical Officer of Health, writes:-
The incidence of common infectious diseases showed little significant change from
last year. There was a welcome reduction in the number of cases of Measles to 800 (1,558),
due in part to the natural bi-ennial epidemic rhythm of the disease but also, we hope, to
increased efforts to secure vaccination of all susceptible children. Waltham Forest compares
well with the National average rate for all standard immunisations with the exception of
vaccination against Smallpox.
One cannot stress too much the importance of prophylactic immunisation. Walthamstow
and Leyton shared 622 cases of diphtheria and 327 cases of smallpox during 1930; because of
effective immunisation these diseases have virtually disappeared as has poliomyelitis with its
ghastly sequel of paralysis. B.C.G. vaccine is playing a prominent part in eradicating tuberculosis
throughout the world and effective vaccines are now available for both measles and
rubella.
But, when the incidence of an infectious disease is reduced, it is even more important
to keep up the proportion of the population immunised. Populations in which a disease has
been present for many generations gradually develop a racial or "herd" immunity to it, as we
have to the common fevers. Without immunisation we should all catch measles in childhood
but few would die from it whereas in isolated communities which have never been exposed to
that virus, such as Eskimo villages, the whole population dies; lacking a pattern of inherited
immunity on which to build, they are overwhelmed by the infection before their bodies can
create sufficient immunity. Recent research into the rejection of transplanted organs has
greatly increased our knowledge of how immunity works in the body and is clearly pointing the
way towards immunisation against that most dreaded disease - Cancer.
There was an insignificant increase in the number of cases of infectious jaundice
notified at 54 (3I). All were investigated and the possibility of (drug) syringe-transmitted
jaundice excluded. Perhaps the most remarkable feature of 1970 in this context was the
extraordinarily low figure for dysentery, only 12 cases being notified against (240) last year.
No effective drug treatment has yet been discovered which will clear patients or carriers with
this disease but much work has been done over the past few years to improve standards of
hygiene, especially in school lavatories, and by health education directed towards parents
and teachers. Perhaps these efforts are beginning to show results but if we have three, or
better, five years without an outbreak I should feel more confident that we are winning.
Our two typhoid cases were both imported; quickly diagnosed and isolated and no
secondary spread occurred. Food Poisoning continued to plague the inhabitants of Waltham
Forest - the numbers notified mean nothing since the usual form of gastro-enteritis though
violent is of such short duration that most sufferers do not even consult their doctor. Though
there were only three deaths from gastro-enteritis this year there can be few of us who entirely
escaped a "tummy upset" due to food poisoning germs. The widespread prevalence of this
infection in an urban community with an unimpeachable water (and milk) supply must give us
cause for concern. Through increased efforts in Health Education and strict enforcement of
the Food Hygiene Regulations we shall make every endeavour to prevent contamination or
faulty storage and handling of food by those employed in food commerce. The increasing use
of "convenience" pre-packed prepared foods greatly increases the risk. Though prevented
from "going bad" by refrigerated storage such foods are often contaminated and once out of
the freezer they rapidly "go off". Infection among the animals, poultry or staff at a modern
high output factory-farm sending frozen carcasses all over the country could produce widespread
outbreaks unless great care is taken to defrost thoroughly and then cook slowly so
that enough heat penetrates right through the meat to ensure that germs deep in the tissues
are also cooked-dead! _ 7 _