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THE WORK OF THE DEPARTMENT
CONTROL OF COMMUNITY DISEASES
Dr.Geoffrey Poole, Deputy Medical Officer of Health, writes:-
This has been a fortunate year without any serious episode of infectious disease. Measles,
thanks to vaccination, had the lowest incidence recorded here with only 297 cases (I,131) and
whooping cough, no doubt due to improved vaccines-, produced only 20 notified cases (130). For
the third year in succession we have escaped a dysentery outbreak with its troublesome sequel of
children excluded from school and mothers losing work. Much credit for this must go to our
colleagues in the Education Department for continued improvement of lavatory facilities in schools
and to the teachers (and our own staff) for inducing improved personal hygiene among the children.
Of exotic diseases we had nine cases of malaria, only two of typhoid fever and one of paratyphoid.
Approximately 1,200 visits were made by the DMOH and/or Control of Infection Sister to cases of
infectious diseases and 568 specimens taken for laboratory examination. In addition visits to newly
arrived immigrants (including those in connection with infectious diseases) amounted to 1,173
including special visits to 300 Asians expelled from Uganda, a total of 2,357 visits in all.
After citing the abandonment of routine vaccination against smallpox (after 120 years) as
the outstanding epidemiological event of 1971 it is ironic that 1972 should see one of the most
explosive outbreaks in Europe of recent times when the entry of a single infected person produced
in Yugoslavia 174 cases, 34 of which were fatal. It is exactly 100 years since the last major
smallpox epidemic in England when in 1871 /72 there were 42,000 deaths, almost 10,000 occurring
in London alone, and the Yugoslav episode, while it warns us to keep alert, must be seen against
the background of the history of the disease. Maps published by the World Health Organisation
show progressive shrinkage of the areas in which quarantinable diseases still exist and there is
no doubt that mass vaccination campaigns in developing countries will soon eradicate smallpox
altogether since man is the only known reservoir for the virus.
The elimination of tuberculosis will be more difficult. It was the only infectious disease
apart from VD to show a significant increase in 1972 to 105 (86) new cases but of these no less
than 64(61%) occurred among the comparatively small immigrant population. An increasing number
of chemotherapy-resistant strains of the tubercle bacillus are being found-often because patients
default and disappear before completing their treatment-so that it is still necessary for all
schoolchildren to be given BCG vaccination if tests show they have insufficient resistance to
protect them from these particularly dangerous strains of bacteria. During 1972 2,032 schoolchildren
were found with insufficient antibody and all were vaccinated.
Venereal disease, or as it is now called sexually transmitted disease, showed an increase
of 14% to 1,785 new cases (1,566). This was not unexpected after the 35% increase 1970/71. It is
doubtful if there is any reduction in the extension of indiscriminate intercourse but there may be a
wider appreciation of the added risk of dispensing with the mechanical protectives formerly used
in casual intercourse before the "Pill" became widely available. Cancer deaths were slightly
increased at 627 (624) of which 188 (187) were primary cancers of the lung due mainly to cigarette
smoking, as some other cancers are now known to be. Total deaths from diseases associated with
smoking were as follows: