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of 1936 and 1937 in the Sutton District and Croydon respectively. Of
these four cases (two in 1947 and two in 1953), three were infected whilst
on holiday on the continent of Europe and the fourth, a boy, contracted the
infection from drinking contaminated water in the vicinity of the Beddington
Sewage Farm.
Paratyphoid fever is in its nature more allied to food poisoning and is
not infrequently contracted from infected food both solid and liquid. It is,
as a result, comparatively more prevalent than true typhoid though it is rare
now for it to give rise to extensive outbreaks. One case was notified during
1957 in a woman of thirty-three years. The source of the infection (type
Taunton) was not established, but it was probably in Battersea where the
patient had visited at the material time a family of relatives all of whom had
recently suffered from "diarrhoea." The patient was discharged well from
Isolation Hospital after a month's treatment.
Dysentery
Since 1950 the yearly incidence of dysentery has increased throughout
the country due almost entirely to the comparatively mild variety caused by
the Sonne organism. It is now endemic in that we are never entirely free
from odd cases, but it is subject to periodic epidemic outbursts. A bowel
infection which is spread mainly by lack of the practise of personal hygiene,
it is particularly liable to attack communities of children such as nurseries
and infant schools. Outbreaks of this nature have occurred in recent years
in the district and they are so explosive in their onset that most of the
individuals at risk are already infected by the time the first cases are recognised.
Children infect one another in the course of school life and each
then proceeds to transmit the illness to most, if not all, the members of his
close family circle. Insistence on strict attention to personal hygiene
especially in the washing of hands after the use of the toilet and before
food for all contacts and due precautions in the nursing of patients succeed
in bringing these outbreaks to an end. Though mild and attended by only
a very low mortality, it can be fatal to otherwise debilitated people and very
young babies.
There was no prevalence in the district during the year. Two cases
were notified. One was a child admitted to a local hospital for treatment
from another area already suffering from the illness. The other was a
National Service man who arrived in this country with the illness after
service abroad. Neither case arose in the district. The child suffered from
a Sonne infection, the service man from the more severe and rarer illness
due to the Shiga organism. Both recovered.
Scarlet Fever
The cases of scarlet fever at 59 were approximately twice as many as in
the year before, which year established a record low incidence for this
illness. Even so, by comparison with the years prior to 1954 prevalence was
very low. Up to 1954 the annual notifications always exceeded 100 being
frequently over 200 in the pre-war years.
In the last few decades the virulence of this infection has undergone
a progressive diminution. It is moreover due to an organism which is
particularly susceptible to modern chemo-therapeutic treatment which
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