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67
Dysentery
The smouldering infection in a day nursery, which had clouded the summer of 1960,
did not recur; and only six cases of dysentery were notified, three from each borough.
This shows a most satisfactory improvement over the two previous years; for there were
66 in 1960, whilst, in 1959, 251 cases occurred in Tottenham alone.
Tuberculosis
Five new cases of tuberculosis, of which four were due to pulmonary infection,
were notified in Tottenham during 1961. In each case the source of the disease lay
in the home environment, so that an epidemiological survey in the respective schools
of these children was not deemed to be necessary.
Diphtheria
A seven-year old boy was admitted to the Infectious Diseases Unit at St. Ann's
Hospital, Tottenham on the 17th February 1961, having presented to his general
practitioner on the previous day with acute tonsillitis. Re-examined by his doctor
on the day of admission, the boy was found to have a severe infection of his neck
glands, despite treatment with penicillin, and suspicions of diphtheria were aroused.
On admission to hospital, the diagnosis was confirmed and prompt anti- diphtheriotic
measures were instituted.
Simultaneously, the school nurse examined the throats of all the children in the
boy's school, paying home visits to those who were absent from school on that day.
The nurse reported that no other child showed evidence of an inflamed throat, and the
subsequent absence of secondary cases confirmed the efficacy of her follow-up.
Meanwhile, the patient responded to treatment and, on discharge from hospital in early
April, he had made a complete recovery.
From time to time during the second half of February, the medical personnel of
the public health department were asked to see cases where the possibility of diphtheria
had been mooted. Fortunately, in each case the diagnosis could be refuted on clinical
grounds; but the episode emphasised the fact that few doctors under the age of 45 year
have seen a case of diphtheria in this country. These incidents served to stress how
necessary it is to maintain a high level of immunity against this disease in the
population, if diphtheria is not again to become epidemic; and, at all clinics in the
Area, the immunisation of infants was actively pressed.
B.C.G. Vaccination
The table following bears record to a year of steady accomplishment in the
maintenance of a B.C.G. programme amongst the thirteen-year old population. Much of
this work is of routine nature, a considerable chore to medical and clerical staff
alike; but there can be no doubt that the pin-pointing of children in contact with
tuberculosis, with early referral to a chest clinic for observation or treatment, and
the measure of immunity given by vaccination to the remaining pupils, are vital, if
unspectacular, forms of preventive medicine. For the second time students from two
technical colleges were incorporated in the scheme and there was a gratifying increase
in the proportion of those approached who received vaccination (74.2% as against 29.4%
last year).