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taken during 1971, in only five cases was Bordetella pertussis (the organism which causes whooping
cough) isolated.
In 1968 the immunisation/vaccination schedule was altered and since that date, vaccination
against whooping cough has been delayed in most cases to the age of six months and has not
been completed until about fourteen months of age. It has been noticed nationally that the case
rates of pertussis in the under one year old relative to those in the 1-4 year old age group, have
increased since the change of schedule and at 22 (16.3%) the number of notifications of whooping
cough in the under one year age group in this area for 1971 is the highest to date. Paroxysmal
cough can be more distressing in the very young than in the older child and undoubtedly, many
such cases are brought to the attention of family doctors by anxious parents resulting in a more
realistic notification rate for this group. The Bordetella pertussis isolation rate has been found to
be higher in this age group also and of the five pernasal-swabs found to be positive which were
mentioned above, three of them were in the under one year of age group and two of these were
in the pre-vaccination age group—one being only six weeks old.
It is clear that throughout the country there is a wide range in the notification rates for whooping
cough which is difficult to explain on epidemiological grounds and undoubtedly, local factors
play an important part in deciding what the rate for a particular health area will be. Any clinically
recognisable difference between whooping cough due to Bordetella pertussis and other agents
would be of great importance as an aid to more positive diagnosis. Also the introduction of a
serological test to confirm a diagnosis of whooping cough would be very valuable and it is likely
that studies on these lines to be undertaken by the P.H.L.S. in the future, may be helpful to bring
about more realistic notification rates.
It seems probable that in the light of current investigations, information may be forthcoming
which will be of value in influencing the immunisation policy of the future.
Health Control Unit, London (Heathrow) Airport
Dr. P. R. Cooper—Principal Medical Officer (Port Health)
The year under review saw the completion of Heathrow's first twenty-five years of life and
the event was duly celebrated on 27th May. The Airport has gone a long way since 1946 when
the terminal accommodation was provided by tents and Nissen huts.
During the same period, changes occurred also in Health Control. In 1946 the responsible
authority was the Urban District Council of Yiewsley and West Drayton; later in that year, there
was a take-over by the Ministry of Health which for a short time exercised direct control before
transferring the responsibility to the Middlesex County Council, which in 1965 passed it to the
Borough of Hillingdon.
In the last twenty-five years, the event which had the greatest impact on the Unit was the
introduction in 1962 of the Commonwealth Immigrants Act. The resulting work-load stemming
from this increased annually. On the other side, there is the general world wide improvement in
the smallpox situation. Not since the winter of 1961/62, when the United Kingdom had its last
major outbreak, has attention been focussed so much upon the Unit and its activities singled out
for so much publicity.
By way of digression, it is interesting to speculate what will be required of a port's Health
Control Unit in the next five years—let alone twenty-five. The World Health Organisation's
eradication campaigns against smallpox have been so successful that it is probable that this
condition will be sufficiently under control for relaxation to be permitted of measures now imposed
at ports of arrival.
On cholera, it may well be that within much sooner than five years passengers will no longer
be required to present certificates of inoculation on arrival.
The effect of other changes upon the Health Control Unit cannot yet be foreseen. The United
Kingdom's entry into the European Community will have some effect upon the present medical
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