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The age distribution of notifiable disease during 1952 is shown in Table V.
Smallpox.—No case of smallpox occurred in the Borough during 1952. Persons arriving in the
Borough from parts of the world where smallpox is prevalent are kept under observation till any chance
of their developing the disease is over.
Freedom from smallpox has resulted in a neglect of infant vaccination. According to the returns
made by local practitioners 348 children under the age of one year were vaccinated in 1952; less than
30 per cent, of the births. Modern travel is such that the risk of importing smallpox is ever present.
Scarlet Fever.—The continuing mildness of this disease is tending to make parents and possibly
doctors, careless about home isolation and other measures to prevent the spread of infection. Of the
161 cases which occurred during the year 46 were admitted to hospital. No death from this disease has
occurred in the Borough since 1937.
Diphtheria.—No explanation other than immunisation can be offered to account for the great
change (shown in Table VI) that has come about in regard to diphtheria. This change can be maintained
only if a sufficiently high proportion of the child population continue to be protected by immunisation.
Unfortunately the removal of the fear of diphtheria has resulted in a fall in the proportion of new babies
being immunised. Complacency is dangerous.
Erysipelas.—The number of notifications, 19, is an increase of seven compared with the previous
two years and one death was due to this disease.
Pneumonia.—Notification of pneumonia showed no change from 1951. The death rate from
pneumonia per 1,000 population was 0.5 as compared with 0.4 in 1951 and 0.3 in 1950. Of the total
pneumonia deaths 86 per cent, occurred at age 65 years and over.
Meningococcal Infection.—Five cases of this disease, formerly classified as cerebrospinal fever,
were notified and one was fatal. The mortality from this disease has fallen considerably since the introduction
of the sulphonamide drugs.
Epidemic Encephalitis.—No notification was received during the year.
Post-Infective Encephalitis.—Encephalitis is known to occur as a complication of other infectious
diseases but no such case was notified during 1952.
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 three cases were notified and there was no death from this disease. Two cases showed
no paralysis but the third child developed some weakness of the left leg and was referred to the orthopaedic
department at West Middlesex Hospital. Poliomyelitis was more prevalent throughout the country in
1952 as compared with 1951 and while this continues the risk of a local epidemic will remain.
Typhoid Fever.—No case of typhoid fever was notified during the year.
Paratyphoid Fever.—During the year seven cases of paratyphoid fever were notified. The
ages of the cases ranged from 6 to 72 years, and two were males. One case occurred in February, five in
September and one in October, and all were single cases. In one case the infection was probably contracted
at an Army Cadet Camp and 33 local contacts were investigated as possible carriers. The remaining six
cases were carefully investigated but no source of infection was traced. None of these patients died. The
infection generally was mild and in four of the cases the diagnosis followed the investigation of an indefinite
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