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INCIDENCE OF AND CONTROL OVER IMECTCTIOUS DESEASES
Seven hundred and seventy-one eases of infectious
disease were notified during the year 1945, an increase of
three hundred and ninety-seven over the previous year. This
increase is mainly due to an epidemic of measles, with five
hundred and thirty notified case. Oases of Diphtheria
increased from six in 1944 to seventeen in 1945. Scarlet
Fever and Whooping Cough declined. No case of Typhoid Fever
was notified. One case of paratyphoid Fever, contracted in
another district, war reported. Other enteric infections
were few. There were two cases of Cerebro Spinal Fever.
One case of Anterior Poliomyelitis occurred.
SCARLET FEVER:- One hundred and twenty-seven cases were
notified, a decline of sixty-nine cases. The case rate was
1.81 per 1000 of population, compared with 1.89 per 1000 of
population for England and Wales. The disease was generally
mild. There was no death.
DIPHTHERIA:- Seventeen cases were notified, an increase
of eleven cases. The case rate was 0,24 per 1000 of population,
compared with 0,46 per 1000 of population for England and Wales,
A majority of the eases were mild or moderate in severity, Three
of the cases had been immunised, and responded well to treatment.
The infecting bacillus was of the gravis type, a highly virulent
and dangerous organism. Eecovery was dependent or. speed in
diagnosis, and in the administration of antitoxin. There was
no death.
DIPHTHERIA ANTIXIN:- Early diagnosis and early treatment
with Antitioxin remain principal safeguards against cortality.
Where there is suspicion of Diphtheria, medical practitioners
should administer Diphtheria Antitoxin at once and in large
doses, while awaiting bacteriological confirmation of the
diagnosis, or should arrange for the case to be removed to
isolation hospital for observation and treatment,
DIPHTHERIA IMMUNISATION:- Diphtheria Immunisation is a
valuable protective measure against Diphtheria, and has reduced
the general incidence and mortality of Diphtheria in this
country, but it Is opportune to reassess its value in the light
of experience.
Experience proves that the protection given by the first
series of injections of toxoid is not permanent. Immunity rises
to its highest lev 1 during the first year after the injections,
and thereafter slowly declines, until at the end of four years
the level of immunity is too low to give protection against the
gravis or severe type of Diphtheria bacillus. Fortunately the
mechanism of protection of the individual has been sensitised
by these first injections, and immunity can be restored by one
further injection. Thus, if a child is immunised at the age of
one year, a further raninforcing injection is necessary at the ago
of five years, preferably before the child enters school, and
subsequent reinforcing injections should be given every four
years until the child leaves school. Thin revival of immunity
by reinforcing injection must become a routine in our campaign
against Diphtheria.
The advantages of artificial immunisation are (1) that
the risk of acquiring infection is reduced, (2) that if acquired,
the illness tends to be modified, and symptoms are less acute,
(3) the response to treatment by antitoxin is more rapid, (4) the
risks of mortality are reduced.
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