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no noticeable impression was made on the progress of the
outbreak, which continued unabated till the end of the year, and
affected in that time 295 mothers, 394 babies and an unknown
but certainly large proportion of the staff. Of the babies
affected, 21 died in the hospital and at least two more are
known to have developed the disease and died after leaving the
hospital. At no time was complete closure of the Unit advised
owing to the ineffectiveness of such action in other similar
outbreaks and to the serious difficulty of arranging alternative
accommodation.
As is usual in such outbreaks, bacteriological investigation
was uniformly negative. In this instance, at least, breast-fed
infants did not appear to have any greater degree of resistance
than the bottle-fed. The large majority of infants in this Unit
(including four of the first five cases) are, in fact, breast-fed,
though many have supplements of lactose-water during the first
few days after birth.
The story of the ultimate subsidence of the epidemic, which
at the time of writing, appears to be complete, remains to be
told in the next Annual Report. It is possible to anticipate,
however, to the extent of mentioning that the decline was
related in point of time to the operation of measures for the
drastic restriction of admissions, thus reducing the rate of
turnover of the Unit without affecting the total number of beds.
Action to improve the ventilation of the wards may well have
contributed, but in fact, preceded the decline by several weeks.
The infant mortality rate of the Borough was not affected
by this outbreak to such an extent as might have been anticipated
owing to the fact that many of the patients involved were
extra-district cases admitted to the hospital under the User
agreement. ,
PNEUMONIA. The number of notifications of pneumonia
—primary and influenzal—received during the year was 249, as
compared with 179 in 1945. Of the number notified, 142 were
males and 107 females. The case rate was 1.52 per 1,000 of
the population. The number of deaths from all forms of
pneumonia was 79, giving a death rate of 0.48 per 1,000 of the
population.
PUERPERAL PYREXIA. The number of cases during the
year was 52, as compared with 29 in 1945. Of these, 43 cases
were removed to hospital. The increase was largely accounted
for by the greater number of births in 1946. The comparative
rates per 1,000 live and stillbirths were: 1945, 0.97; 1946, 1.16.
OPHTHALMIA NEONATORUM. The number of cases
during the year was 9—6 males and 3 females. Three of these
cases were removed to hospital.
ACUTE POLIOMYELITIS. There were no cases of this
disease during the year.
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