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13
EPIDEMIOLOGY
(by A. Shaw, M.D., B.S., D.P.II.,
Deputy Medical Officer of Health)
Infectious Disease
23 diseases are notifiable to the Medical Officer of Health.
These include common diseases such as pneumonia and
whooping cough and exotic ones such as plague and cholera,
which have not been recorded in this country for decades.
The aim of the infectious disease legislation is to inform the
Medical Officer of Health as quickly as possible so that
appropriate measures may be taken. The diseases are notified
by the patient's medical attendant, who receives a fee from the
local authority.
Notification
In a number of the diseases such as smallpox and typhoid,
immediate notification is imperative so that contacts can be
traced and prevention of spread started; such diseases are
notified rapidly and completely by doctors who are alive to the
needs of the community. Other infectious diseases, such as
measles, whooping cough and pneumonia, are notified incompletely
and as a result of this only a rough approximation can
be made of the extent of the disease in the community, although
an indication of rise or fall in incidence can be noted. In this
category of incompletely notified disease we find that only a
small proportion of doctors make notifications and, as a result
of this, a first reading of the geographical incidence of the
disease would seem to indicate that it was occurring only in
certain parts of the borough until it is realised that it is in
these parts of the borough that the notifying doctors practise.
In addition to the statutory sources of information on
infectious disease incidence, very useful epidemiological
intelligence is obtained from schools and from the Ministry of
Pensions and National Insurance who report on the number of
claims for sickness benefit each week.
Measles
Appendix 1 shows that 4,222 cases of infectious disease
were notified during the year, and that 3,393 of these were
measles. From an epidemiological viewpoint, it does us no
good at all to know that there were 3,393 cases of measles;
we knew that 1965 would be a measles year and we knew also
that the incidence would fall largely on children up to the
age of 7 or 8. If measles vaccination ever became as acceptable
and universal as vaccination against poliomyelitis there would
be value in notification because it would indicate success or
otherwise of the vaccine but at the present it means very
little.