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The age distribution of notifiable disease during 1951 is shown in Table V.
Scarlet Fever.—This disease continued to be of a mild type. No death from this disease has
occurred in the Borough since 1937. Of the 67 cases 26 were admitted to hospital.
Diphtheria.—No case of diphtheria occurred in the Borough during 1951. Dr. Logan, Chief
Medical Statistician of the Registrar-General's Department, writing on " recent trends of diphtheria"
stated:— ,
" Almost 10,000 persons died from diphtheria in England and Wales in 1901; 32 in 1951. From being
one of the most serious causes of death of children in this country, diphtheria has now fallen to a position of
numerical insignificance.
The situation is now being reached—a situation scarcely dreamed of in 1940 when the national
immunisation campaign started—where the eradication of diphtheria as an indigenous disease in this
country can be foreseen as a very real possibility within the next few years, provided there is no slackening
in the immunisation efforts that have been so dramatically successful in the past 10 years. Complacency
resulting from what has already been achieved, or loss of interest or confidence in immunisation, may
mean that diphtheria will go on occurring endemically and epidemically in this country indefinitely with
the ever-present risk of a return to high mortality; but a vigorously continued immunisation campaign,
combined with existing methods of epidemic control, may free us entirely from the disease except for the
occasional imported case."
The number of children attending for immunisation has fallen again this year. If this disease is to
be kept under control a much higher proportion of young children must be protected. The future record
of diphtheria in this Borough will be a measure, not of the efficiency of the Health Department, but of the
intelligence and foresight of parents.
Erysipelas.—Though 12 cases were notified no death was due to this disease.
Pneumonia.—There was a slight reduction in the notifications of pneumonia when compared with
1950. The death rate from pneumonia per 1,000 population was 0.4 as compared with 0.3 in 1950 and 0.5
in 1949. Of the total pneumonia deaths 13 per cent. occurred at age 0-4 years and 70 per cent. at age
65 years and over.
Meningococcal Infection.—Five cases of cerebrospinal fever were notified during the year and
one death was due to this disease. The mortality from this disease has fallen considerably since the introduction
of sulphonamide drugs.
Epidemic Encephalitis.—No case was notified during the year.
Post-Infective Encephalitis.—Encephalitis is known to occur as a complication of other infectious
disease. One case following Mumps was notified.
Poliomyelitis and Polioencephalitis.—These names describe two types of infection by the same
virus; in the former the spinal cord is affected and in the latter the brain bears the brunt of the infection.
During the year 4 cases were notified and there was no death from this disease. Two cases only developed
any paralysis; on discharge from the fever hospital one was transferred to a orthopaedic hospital and the
other referred to orthopaedic out-patient department for further treatment.
This disease, which used to occur as sporadic cases or small outbreaks, has been generally prevalent
throughout the country for some years. Though the widespread epidemic of 1947 has not been repeated
and the incidence is tending to fall, there is no inidcation that the disease is returning to the comparative
rarity of "20 years ago.
Typhoid Fever.—One case of typhoid fever was notified during the year. The patient had returned
from India via Egypt a short time before the onset of the illness and the infection appeared to have been
picked up abroad. No secondary cases occurred.
Paratyphoid Fever.—During the year one case of paratyphoid fever was notified. This isolated
case was a young child, no secondary cases occurred but the source of the infection was not traced.
Dysentery.—This disease shows great variations in prevalence from year to year and from place
to place. During the year 77 cases were notified as compared with 6 cases in 1950. Two were residents'
of Brentford and Chiswick notified from West Middlesex Hospital, 6 were members of the nursing stall
of West Middlesex Hospital, 3 were members of the nursing staff of South Middlesex Infectious Diseases
Hospital and the remainder resided in various parts of the Borough. The age range varied from 3 months
to 72 years and 53 per cent. were under the age of 5 years. There were 39 primary cases and the remaining
38 cases were brought to light during the investigation of the primary cases, In many of these 38 cases
the illness had been so slight that no treatment or medical attention had been sought and but for the search
for sources of infection by the Department these cases would have been missed. Among the 66 cases occurring
in families in the Borough 34 were single cases, while 2 cases each arose in 7 houses, 3 cases each in
4 houses and 6 cases in one house. This infection spread to the day nurseries. In Heston Day Nursery
18 children were affected, in Acton Lodge Day Nursery 2 staff and one child and in Blenheim House Day
Nursery 1 staff and 5 children.
The infection in all cases was of the Sonne type and the illness was mild in practically every case.
The mildness of the illness is deceptive and unless it is constantly kept in mind cases are likely to be missed.
In all cases of diarrhoea in children and on the least suspicion in adults a specimen of faeces should be sen
for bacteriological investigation. Only by constant vigilance will this disease be kept under some degre
of control.
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