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Infectious Disease in England and Wales WEEK ENDED JULY 5
114 about 2-52% ; so it may be fairly claimed that overcrowding has been reduced by a third in the ten years. The housing schemes of the city council have certainly
played an important part in this improvement, though reduction in the size of families must also be a factor. He notes that when married couples have to share a house with their parents or others, though they may not be overcrowded by any official standards, they are sometimes irritated and unhappy. In the 1936 survey, overcrowding in the central wards in the was 8-7 %, as compared with 3’3 % in 1946 ; middle ring the figure has fallen from 2-7 to 1’3%, and in the outer ring from 2’0 to 1.9 %. The excess of families over houses’is 15,533, and 25,000 houses are due for demolition. The net housing requirement cannot be exactly assessed, because much could be done by redistribution. Moreover, when an overcrowded family is moved into a new house, their former house can be used for a smaller family. The number of new houses needed is therefore smaller than the number of cases of overcrowding : the Ministry of Health put it at 55 % of the overcrowding figure. Dr. Newsholme thinks that, quite apart from future slum clearance and redevelopment, some 7000 houses are needed to meet this due proportion of the present excess of families over houses, plus some 18,000 to get rid of an equivalent proportion of bedroom overcrowding, plus 20,000 houses, to be built over ten years, to meet natural increase of population. The last two figures overlap to some extent.
Smallpox first patient in
this district, which is removed on July 9. She is aged 19 and unvaccinated. She sickened on July 3 and a confluent rash appeared on July 6. Numerous contacts are under surveillance. At Bilston the diagnosis in a boy, aged 10, removed on July 3, has now been confirmed. Modified rash appeared on July 2. He had been vaccinated for the first time on June 23. Contacts are still under surveillance. Barhsley.-The daughter and son-in-law of the woman, aged 62, admitted to the smallpox hospital on June 30 were removed on July 11 when smallpox rashes appeared. Both had been vaccinated on July 2, one primarily and the other after an interval of 30 years. Southampton.—The suspected case removed from the Carnarvon Castle on July 8 is suffering from Willenhall.—The
near
Bilston,
was
Bulbar and respiratory paralysis is unusually frequent, and respirators are in demand. In one extrametropolitan borough 7 children have been admitted to the isolation hospital since June 18, 5 of them in the first eleven days of July ; of these, 2 required treatment in respirators. Tonsillectomy had been performed on 1, aged 4 years, a fortnight before signs of bulbar paralysis appeared. It has been advisedthat when poliomyelitis is prevalent and throat operations should, if possible, be nose
postponed. An
assistant
master
at
a
preparatory school
at
Aldenham, Herts, has died of poliomyelitis, and another master and a boy have contracted the disease. The school has been closed. During the week ended July 5, 64 cases of cerebrospinal fever were notified. The increase in notifications, contrary to the expected seasonal decline, may be an expression of the increased incidence of anterior poliomyelitis with well-marked meningeal signs at the onset. IN EAST PRUSSIA.-Epidemic bubonic plague in Konigsberg during June and has caused many deaths among the civilian population.
PLAGUE
appeared
Infectious Disease in
England
WEEK ENDED JULY
and Wales
5
Notifications.—Smallpox, 3 ;; scarlet fever, 966; whooping-cough, 2240 ; diphtheria, 188 ; paratyphoid, 8 ; typhoid, 15 ; measles (excluding rubella), 10,269; pneumonia (primary or influenzal), 353 ; cerebrospinal fever, 64 ; poliomyelitis, 79 ; polioencephalitis, 9; encephalitis lethargica, 4 ; dysentery, 57 ; puerperal pyrexia, 144 ; ophthalmia neonatorum, 61. No case of cholera, plague, or typhus was notified during the week. Of the 3 smallpox cases, 2 at Barnsley, Yorks.
were
notified at Bilston, Staffs, and 1
Deaths.-In 126 great towns there were no deaths from enteric fever or scarlet fever, 2 (1) from diphtheria, 5 (0) from measles, 11 (1) from whooping-cough, 52 (4) from diarrhoea and enteritis under two years, and 5 (0) from influenza. The figures in parentheses are those for London itself. The number of stillbirths notified during the week was 238 (corresponding to a rate of 25 per thousand total births), including 31 in London.
chickenpox. The Times of July 14 reports that the first case in Dublin since 1900 was discovered on board an American ship which has arrived from California. Up to July 12 there had been 10 cases of smallpox in two generations in Calais, and 1 in Lille, secondary to the focus in Calais.
Poliomyelitis Registrar-General’s returns for the week ended record 79 notifications, compared with 9 in the corresponding week of 1946. This figure has rarely The
July 5
been exceeded since the disease became notifiable in 1912. The maximum recorded incidence was in 1938 (1489 cases) ; in the first twenty-seven weeks of that year 127 cases were notified. The figures for the corresponding periods of 1946 and 1947 have been 206 and 435 (uncorrected). The disease is widely spread. Notifications in the week ended July 5 were received in 65 sanitary districts, and were mainly singletons. However, since July 5 multiple cases have been reported from several districts, and in all probability a " new high " occurred in the past week. An unprecedented prevalence is to be
expected. Acute onsets with sharp meningeal reactions, leading to a diagnosis of meningitis or meningo-encephalitis, appear to have been a feature in the present outbreak. In such cases the preparalytic stage lasts some days, and it may be presumed that infectivity is greatest in this period. Early isolation on suspicion before the onset of paralysis is probably the most effective action towards preventing the spread of the disease.
Parliament ON THE FLOOR OF THE HOUSE
THE Indian Independence Bill came before the House for discussion on July 10 and passed its second reading. So after over 250 years a British chapter of Indian history is ending. The power of government in India is to be handed over to the two Dominions by Great Britain on August 15, and it is significant that the sobering effect of responsibility on India has been great. It is now clear that the British business community will remain, and it is hoped that many British civil servants, doctors, and perhaps soldiers will remain too in the employ of one or other of the Indian governments. The great problems of India are food, health, and agriculture. Industry on any very large scale has yet to be i developed. How will India deal with her recurrent famines and epidemics ? How will India raise the standard of health of her peoples ? There certainly will be in India vast scope for great health and nutrition
changes. Turning from East to West, Parliament has paid attention during the week to problems of the reconstruction of Europe. Can we reconstruct before the dollar line of credit runs out ? Or must we willy-nilly get help from the Marshal offer on some new basis : That we shall need all our ingenuity in planning to keep our
nation fit and well is clear. 1. Lancet,
Extra food for children.
1946, i, 972.
played an important part in this improvement, though reduction in the size of families must also be a factor. He notes that when married couples have to share a house with their parents or others, though they may not be overcrowded by any official standards, they are sometimes irritated and unhappy. In the 1936 survey, overcrowding in the central wards in the was 8-7 %, as compared with 3’3 % in 1946 ; middle ring the figure has fallen from 2-7 to 1’3%, and in the outer ring from 2’0 to 1.9 %. The excess of families over houses’is 15,533, and 25,000 houses are due for demolition. The net housing requirement cannot be exactly assessed, because much could be done by redistribution. Moreover, when an overcrowded family is moved into a new house, their former house can be used for a smaller family. The number of new houses needed is therefore smaller than the number of cases of overcrowding : the Ministry of Health put it at 55 % of the overcrowding figure. Dr. Newsholme thinks that, quite apart from future slum clearance and redevelopment, some 7000 houses are needed to meet this due proportion of the present excess of families over houses, plus some 18,000 to get rid of an equivalent proportion of bedroom overcrowding, plus 20,000 houses, to be built over ten years, to meet natural increase of population. The last two figures overlap to some extent.
Smallpox first patient in
this district, which is removed on July 9. She is aged 19 and unvaccinated. She sickened on July 3 and a confluent rash appeared on July 6. Numerous contacts are under surveillance. At Bilston the diagnosis in a boy, aged 10, removed on July 3, has now been confirmed. Modified rash appeared on July 2. He had been vaccinated for the first time on June 23. Contacts are still under surveillance. Barhsley.-The daughter and son-in-law of the woman, aged 62, admitted to the smallpox hospital on June 30 were removed on July 11 when smallpox rashes appeared. Both had been vaccinated on July 2, one primarily and the other after an interval of 30 years. Southampton.—The suspected case removed from the Carnarvon Castle on July 8 is suffering from Willenhall.—The
near
Bilston,
was
Bulbar and respiratory paralysis is unusually frequent, and respirators are in demand. In one extrametropolitan borough 7 children have been admitted to the isolation hospital since June 18, 5 of them in the first eleven days of July ; of these, 2 required treatment in respirators. Tonsillectomy had been performed on 1, aged 4 years, a fortnight before signs of bulbar paralysis appeared. It has been advisedthat when poliomyelitis is prevalent and throat operations should, if possible, be nose
postponed. An
assistant
master
at
a
preparatory school
at
Aldenham, Herts, has died of poliomyelitis, and another master and a boy have contracted the disease. The school has been closed. During the week ended July 5, 64 cases of cerebrospinal fever were notified. The increase in notifications, contrary to the expected seasonal decline, may be an expression of the increased incidence of anterior poliomyelitis with well-marked meningeal signs at the onset. IN EAST PRUSSIA.-Epidemic bubonic plague in Konigsberg during June and has caused many deaths among the civilian population.
PLAGUE
appeared
Infectious Disease in
England
WEEK ENDED JULY
and Wales
5
Notifications.—Smallpox, 3 ;; scarlet fever, 966; whooping-cough, 2240 ; diphtheria, 188 ; paratyphoid, 8 ; typhoid, 15 ; measles (excluding rubella), 10,269; pneumonia (primary or influenzal), 353 ; cerebrospinal fever, 64 ; poliomyelitis, 79 ; polioencephalitis, 9; encephalitis lethargica, 4 ; dysentery, 57 ; puerperal pyrexia, 144 ; ophthalmia neonatorum, 61. No case of cholera, plague, or typhus was notified during the week. Of the 3 smallpox cases, 2 at Barnsley, Yorks.
were
notified at Bilston, Staffs, and 1
Deaths.-In 126 great towns there were no deaths from enteric fever or scarlet fever, 2 (1) from diphtheria, 5 (0) from measles, 11 (1) from whooping-cough, 52 (4) from diarrhoea and enteritis under two years, and 5 (0) from influenza. The figures in parentheses are those for London itself. The number of stillbirths notified during the week was 238 (corresponding to a rate of 25 per thousand total births), including 31 in London.
chickenpox. The Times of July 14 reports that the first case in Dublin since 1900 was discovered on board an American ship which has arrived from California. Up to July 12 there had been 10 cases of smallpox in two generations in Calais, and 1 in Lille, secondary to the focus in Calais.
Poliomyelitis Registrar-General’s returns for the week ended record 79 notifications, compared with 9 in the corresponding week of 1946. This figure has rarely The
July 5
been exceeded since the disease became notifiable in 1912. The maximum recorded incidence was in 1938 (1489 cases) ; in the first twenty-seven weeks of that year 127 cases were notified. The figures for the corresponding periods of 1946 and 1947 have been 206 and 435 (uncorrected). The disease is widely spread. Notifications in the week ended July 5 were received in 65 sanitary districts, and were mainly singletons. However, since July 5 multiple cases have been reported from several districts, and in all probability a " new high " occurred in the past week. An unprecedented prevalence is to be
expected. Acute onsets with sharp meningeal reactions, leading to a diagnosis of meningitis or meningo-encephalitis, appear to have been a feature in the present outbreak. In such cases the preparalytic stage lasts some days, and it may be presumed that infectivity is greatest in this period. Early isolation on suspicion before the onset of paralysis is probably the most effective action towards preventing the spread of the disease.
Parliament ON THE FLOOR OF THE HOUSE
THE Indian Independence Bill came before the House for discussion on July 10 and passed its second reading. So after over 250 years a British chapter of Indian history is ending. The power of government in India is to be handed over to the two Dominions by Great Britain on August 15, and it is significant that the sobering effect of responsibility on India has been great. It is now clear that the British business community will remain, and it is hoped that many British civil servants, doctors, and perhaps soldiers will remain too in the employ of one or other of the Indian governments. The great problems of India are food, health, and agriculture. Industry on any very large scale has yet to be i developed. How will India deal with her recurrent famines and epidemics ? How will India raise the standard of health of her peoples ? There certainly will be in India vast scope for great health and nutrition
changes. Turning from East to West, Parliament has paid attention during the week to problems of the reconstruction of Europe. Can we reconstruct before the dollar line of credit runs out ? Or must we willy-nilly get help from the Marshal offer on some new basis : That we shall need all our ingenuity in planning to keep our
nation fit and well is clear. 1. Lancet,
Extra food for children.
1946, i, 972.