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"The lay press still regards even the single case as news", and an alarmist
view in many quarters is understandable. It must be stressed, however,
that absence of fear and anxiety plays a most important part in recovery,
and in framing suggestions for the prevention of the disease, gloom and
despondency must be avoided.
Many workers in the field of infectious disease still insist upon strict
quarantine of all contacts, but, as has recently been pointed out by those
of the medical profession most qualified to speak, isolation would seem
to have played a very minor role in the prevention of spread of this
disease. In his article in the British Medical Journal Dr. Anderson says:
"For the 'exotic' infections such as smallpox, in which the epidemic
results from single introductions into a virgin community, strict isolation
pays dividends because of the comparative ease with which all affected
cases may be recognised. In a situation where the mass of infection is
unrecognised and unrecognisable it is difficult to believe that strict
isolation of all contacts is likely to succeed in limiting spread. This is,
however, a thorny problem, which in the present state of our knowledge
cannot be adequately solved by emotional argument, and it is well that
the subject is being thoroughly investigated.
"So far as the welfare of the individual contact is concerned, the
only advice which it seems reasonable to give is to avoid all excessive
physical activity. Should any febrile episode occur the patient must go
to bed at once and remain there for one week. Even when this practice
is carried out faithfully paralysis may still develop, but experience suggests
that the subsequent illness is mild."
One preventive measure of practical value, which is always adopted
by this Public Health Department in the summer months, is the discontinuance
of injections for the immunisation of children against diphtheria
and whooping-cough. Additional measures are an extremely strict control
of the water in the swimming bath at Beddington Orphanage, a sufficient
dose of chlorine being maintained not only to keep the water sterile,
but also to leave a small residual content of free chlorine. General rules
of conduct are laid down and distributed in pamphlet form to known
contacts of cases.
As it is now known that patients suffering from, and carriers of,
poliomyelitis, excrete the organism in their faeces, particular attention
to the washing of hands after the use of the toilet and before meals is
important.
Only 16 new cases of tuberculosis were notified during 1954, or
approximately half the number of cases notified in 1953.
Since the end of the war, a great amount of work has been done by
all connected with the control of tuberculosis—Government departments,
Regional Hospital Boards and the Medical Research Council—to try
and reduce the incidence and improve facilities for treatment of tuberculosis.
This work is now beginning to bear fruit.
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