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MEASLES
1971 was a "measles year". At any rate taking into account the bi-annual outbreaks of
measles which has been the accepted pattern of the disease for some time (see table below),
it should have been a measles year and at 1,208 notifications the incidence of the disease in the
Borough was certainly higher than one would have wished in the fourth year of a measles
vaccination programme.
No doubt the accumulation of non-immune children during 1969 referred to in my last
Report has continued to contribute to a higher incidence of the disease. The number of cases
notified during 1971, however, is only one-third what one would have expected if the bi-annual
pattern had continued and with noticeably few complications occurring amongst those children
who developed the disease, the practice of routine visits by Health Visitors of all cases of measles
occurring in the under 5 year old group was discontinued in 1971, thereby releasing these hard
pressed officers for other more essential duties.
It is confidently expected that the incidence of measles in the community in future years
will be considerably reduced and the pattern of the disease will continue to be reviewed with
interest.

CHOLERA SURVEILLANCE
As from 18th September, 1970, a valid international certificate of vaccination against cholera
was required of every traveller who at any time during the five days immediately prior to his arrival
in the United Kingdom had been in any country, any part of which had been notified to the World
Health Organisation as currently infected with cholera. A single injection of vaccine given not
less than six days and not more than six months previously is accepted as evidence of validity.
Travellers arriving in this country who have visited an infected area within the previous five days
and are unable to produce a valid certificate of vaccination are placed under surveillance for the
remainder of the incubation period.
The Medical Officer of Health of the district of destination is informed of each traveller arriving
in the U.K. who requires surveillance and the Principal Medical Officer (Port Health) comments
on page 26 on the problems presented to the Unit by this requirement.
During 1971, two hundred and three (203) persons arrived in Hillingdon from areas in which
cholera was currently present and were placed under surveillance. Most of those placed under
surveillance were persons arriving home following holiday trips abroad, chiefly from Spain and
Portugal although a few were travellers from Africa and India.
Two of those placed under surveillance developed gastro intestinal symptoms while still
within the cholera incubation period but none of these proved to be a case of cholera although
organisms of the salmonella group were isolated in one instance.
DYSENTERY
Of the 38 cases of dysentery notified, the majority referred to persons infected with Sh. sonnei
organisms although one case of infection due to Sh. flexneri type 6 was reported. There was also
one case of amoebic dysentery notified. This was a lady from overseas who although symptom
free, was found to be a symptomless excreter of this organism during a routine investigation. Her
condition was treated at the Hospital for Tropical Diseases.
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