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Malaria
Two cases of malaria were recorded. One patient was admitted to the Hospital for Tropical
Diseases where parasites of Plasmodium malariae were found in the blood films. The second case,
admitted to St. John's Hospital, Uxbridge, was one of malignant tertian malaria.
Cholera
The year past saw the extension of cholera into Spain and Portugal from the North African
countries. Barcelona and Valencia Provinces and the suburbs of Lisbon became infected areas
and from these areas cases were imported into Sweden and France. The United Kingdom reported
one case imported from Tunisia.
Passengers coming from infected local areas in such countries were placed under surveillance
unless their international certificates of vaccination against cholera were valid, and all passengers
arriving on flights from these areas were given a Council of Europe (Partial Agreement) Yellow
Warning Card.
Since so many British holiday-makers visit Spain and Portugal each year, the decision to
subject flights to health control placed a considerable burden upon the Unit's staff, as well as
causing nuisance to the travelling public.
There is a certain confusion of thought at present regarding policy on cholera and what
measures should be taken to prevent its importation. Even the efficacy of cholera immunisation
itself is in dispute. Towards the end of 1970, the USA decided that cholera vaccination certificates
would no longer be required from travellers arriving there, even when they came from infected
areas. There are many in the United Kingdom who support this action, but owing to the Government's
obligations under the Administrative Arrangements of the Council of Europe (Partial
Agreement) and its inability to act unilaterally, similar action cannot yet be taken in the United
Kingdom, although it must be recognised that within the countries signatory to the Council of
Europe (Partial Agreement) there may be considerable variation in standards of hygiene, of water
supplies and of sewage disposal.
Until cholera spread from the Far East to the Middle East, North and West Africa in 1970,
it was not the practice at ports of arrival in the United Kingdom to require a cholera vaccination
certificate and it is encouraging to note that the whole question is to be reviewed by the Council
of Europe Public Health Committee and the Group of Experts in 1972. The number of passengers
placed under surveillance was 4,928.
MEDICAL EXAMINATION OF COMMONWEALTH IMMIGRANTS
The total number of Commonwealth Immigrants referred to the Medical Inspectors over the
last five years was:
1971 39,961
1970 44,611
1969 44,575
1968 46,828
1967 16,061
The number of Forms Port 23 completed in 1971 was 62 (69 in 1970).
The categories of those immigrants seen in 1971 was:
(a) Voucher-holders or entitled dependants 28,976
(b) Non-entitled dependants 10,880
(c) Those appearing to be mentally or physically abnormal 19
(d) Those appearing not to be in good health 32
(e) Those mentioning health as a reason for their visit 54
The number of refusals following medical recommendation was 12.
Mental instability 7
Pulmonary tuberculosis 2
Drug addiction 1
Congenital lung disease 1
Senile degeneration 1
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