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symptoms but were negative. The school was visited by a Senior
Medical Officer, who found the standard of hygiene satisfactory. All
cases were cleared by the end of June except for one family, which
continued positive until July.
Apart from these outbreaks, individual notifications of dysentery
resulted in the investigation of 181 families involving 396 people all
of whom were tested. Of these 97 positive cases of dysentery were
found in 36 families, all others being negative. It is routine investigation
of this kind that keeps dysentery under control in this country.
Meningitis
There were three deaths from meningitis. The first was a 15
year old schoolboy who died from staphylococcal meningitis after a
brief illness—and before a doctor had been called.
The second case was a one year old boy and again the cause of
death was staphylococcal meningitis and the illness was brief, less
than 24 hours.
The third case was a 21 year old man who died in hospital after
two days' illness. The cause of death was given as meningococcal
meningitis.
In all three cases contacts were tested and kept under surveillance
and prophylactic treatment given to any considered to be at risk.
All results were negative. There was no apparent connection between
the cases, which were in different parts of the Borough.
Four other cases of meningitis and three contacts were also investigated
during the year.
Poliomyelitis
One case, with some paralysis of one leg, occurred during the
year in a schoolgirl aged eight years, who had not been immunised,
as her parents had not accepted immunisation. There was a delay
of seven weeks before a doctor was called in. All the immediate
family contacts were immunised and school children in the family were
excluded from school for the necessary period. Contacts were widespread
as the illness occurred over the Christmas holiday when relations
were visiting. The patient's school was visited, preventive
measures were arranged and advice on hygiene was given. It was
thought to be too late for general immunisation of pupils, 76% of
whom were, in any case, already immunised. Although no organisms
were isolated from specimens, probably because of the delay in seeking
medical advice, it was considered by the various doctors in contact
with the case that the clinical symptoms clearly indicated poliomyelitis.
The Chief Medical Officer of the Department of Health and Social
Security was informed and he in turn notified the World Health
Organisation.
Smallpox
Twenty-three persons arriving from abroad without a valid certificate
of vaccination, and three persons who were flight contacts of a
suspected case of smallpox, were kept under surveillance for the
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