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The Society of Medical Officers of Health
THE SOCIETY OF MEDICAL OFFICERS OF HEALTH Maternity and Child Welfare Group SONNE D Y S E N T E R Y A meeting of the Group was held in the Royal Microscopical Society Library, Tavistock House, W.C.1, on February 2nd. The president, Dr. Dorothy F. Egan, was in the chair and introduced the speaker, Dr. Ian Taylor, principal medical officer and epidemiologist to the London County Council who spoke on " Sonne Dysentery," his lecture being~illustrated by slides. Dr. Taylor pointed out that the incidence of Sonne dysentery had risen since 1945, and had shifted in prevalance from rural to urban areas, and the age incidence had changed from the pre-school to the young school child. Before 1947, the incidence of Sonne dysentery showed a secondary peak of prevalance in the autumn. This secondary peak had now disappeared, suggesting that there was less association now with food-borne infections. That Sonne dysentery was an intestinal infection with a winter prevalence and resembled measles epidemiologically rather than enteric fever suggested that Sonne dysentery might be spread by contact. A study of infection rates in a family showed that it spread quickly, half of the child contacts being affected. Dr. Taylor showed that, for London, the distribution of Sonne dysentery was related to overcrowding which fitted in with the view that close contact was an important factor in the spread of the disease ; and that the incidence in any town might vary considerably in different years might be related to the development of immunity. In the attack rates in 1955 more than half the total notified cases were aged 5 to 14 years and the rate in this age group had now risen to about half that in the pre-school child. Dr. Taylor showed the fall in incidence related to the school holiday period at Easter and the subsequent rise on re-opening of the schools. This might be related to the sanitary accommodation in schools and transmission of the disease by way of contaminated water-closets. Dr. Taylor pointed out the need for a new type of water closet and of a suitable disinfectant for lavatory seats, something less strong than Lysol. On the question of prevention of spread of disease the symptomless carrier was nothing like as dangerous as the active case. Therefore the need in a community was to exclude all cases with symptoms. Of the mass bacteriological survey for carriers, Dr. Taylor pointed out that it was always chasing 24 hours behind the disease and that carriers should be sought as soon as the epidemic began. Should a substantial number of symptomless carriers be found, it was no good to think then of the action to take but always to relate work done to the results achieved. Probably of more value was the mass bacteriological survey at a later stage. On prophylaxis, the sulphonamides had a place but Dr. Taylor stated that the widespread use of streptomycin was not advised. In answering questions Dr. Taylor stressed that more information was needed on the question of immunity to Sonne dysentery and this could be obtained by followup of cases in a second outbreak. If more evidence was available on the question of immunity interest in immunisation would be stimulated. 38
THE SOCIETY OF MEDICAL OFFICERS OF HEALTH
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H o m e Counties Branch A meeting of the Branch, which was attended by about 30 members, was held on February 8th, at the London School of Hygiene. In the unavoidable absence of Dr. Townsend, the President, the chair was taken by Dr. Belam. Dr. M. E. M. Herford, D.S.O., M.C., M.B.E., M.D., D.P.H., Appointed Factory Doctor, Windsor & Slough district, gave an excellent address entitled" The Appointed Factory Doctor and the School Health Service." This was followed by a very full discussion, and Dr. Herford was warmly thanked for his address, which it is hoped will be published later in PUBLIC HEALTH. Midland Branch HEALTH VISITORS' WORKING PARTY The third meeting of the session was held at Lancaster Street Welfare Centre, Birmingham, on December 6th, with Dr. J. F. Galloway, president-elect in the chair. The Branch Council had considered the composition of the recently appointed " Convalescent T r e a t m e n t " Working Party, noting that no medical officer of health was included. The attention of the Society was being drawn to this omission. This action was approved. In view of the increasing trend to include Welfare functions in the Duties of the medical officer of health, the Branch Council had resolved to submit a proposal to the Society that a Welfare Services Group should be established, in addition to the Mental Health and Teaching Groups now being formed. This action was approved. In opening a discussion on the Report of the Health Visitors' Working Party, Dr. J. F. Warin, medical officer of health, Oxford, thanked the Branch for giving him the opportunity of returning to Birmingham and of speaking to former colleagues and friends about the Report of this Working Party of which he had been a member. The Party had arrived at a unanimous finding, due to the qualities of the chairman and vice-chairman, and to the mutual give and take which had been a feature of the two years' work. A close working relationship between general practitioner and medical officer of health had been accepted as essential at the outset. Members of the Steering Committee had been called upon from time to time, but that Committee had only met on two occasions, at the beginning, and, at the end, to receive the final Report. The true value resulting from the two years' work lay, in his opinion, not in the Report but rather in the thought given in the preparation and submission of evidence. Dr. Warin referred to the health visitor as the Family Visitor and the only general purposes social worker, although her first care would always be " mother and child " ! Specialisation was warranted only in special circumstances, perhaps on a part-time basis, while the combined worker should always be a qualified health visitor. He preferred the family nurse combining health visitor and district nurse functions as the general practitioner's right hand man, unencumbered by the urgent midwifery call, to any scheme where all three functions were combined. Her status must be enhanced and, there was no doubt, the more a general practitioner knew of her work, the more appreciative was he of the help she could give. There must be regular contact also with hospital Almoners and ward sisters. There should also be the fullest co-operation with midwives, home nurses and social workers. On the question of training, Dr. Warin drew attention to the Report of the Nurse Training Working Party, with a plea for integration of the training of the
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PUBLIC HEALTH VOL. LXXI NO. 1
general nurse, midwife and H.V., and in his closing remarks, spoke of the serious manpower situation and hoped that some effort would be made to interest schoolleavers in the possibilities of health visiting as a career and to inform hospital nurses of the work and opportunities available. Dr. J. F. Galloway, and Drs. Tabbush, Pickup, Griffin, Findlay and Milligan, contributed to the discussion and a cordial vote of thanks was accorded to Dr. Warin on the proposal of Dr. B. M. Thompson, seconded by Dr. Hatherley.
Correction--We regret that owing to an unfortunate error our obituary notice last month recorded the date of Dr. W. G. Clark's qualification in medicine as 1918. This should, of course, have been 1910 for, in fact, Dr. Clark served throughout the First World War in the Royal Navy.
BACK NUMBERS OF PUBLIC HEALTH
REQUIRED
The medical secretary requests the return by any members of the Society who do not wish to retain them of copies of Public Health issues of April and August, 1956, and January and February, 1957, which are needed to complete orders for overseas libraries. Postage will be refunded.
THE SOCIETY OF MEDICAL OFFICERS OF HEALTH
39
H o m e Counties Branch A meeting of the Branch, which was attended by about 30 members, was held on February 8th, at the London School of Hygiene. In the unavoidable absence of Dr. Townsend, the President, the chair was taken by Dr. Belam. Dr. M. E. M. Herford, D.S.O., M.C., M.B.E., M.D., D.P.H., Appointed Factory Doctor, Windsor & Slough district, gave an excellent address entitled" The Appointed Factory Doctor and the School Health Service." This was followed by a very full discussion, and Dr. Herford was warmly thanked for his address, which it is hoped will be published later in PUBLIC HEALTH. Midland Branch HEALTH VISITORS' WORKING PARTY The third meeting of the session was held at Lancaster Street Welfare Centre, Birmingham, on December 6th, with Dr. J. F. Galloway, president-elect in the chair. The Branch Council had considered the composition of the recently appointed " Convalescent T r e a t m e n t " Working Party, noting that no medical officer of health was included. The attention of the Society was being drawn to this omission. This action was approved. In view of the increasing trend to include Welfare functions in the Duties of the medical officer of health, the Branch Council had resolved to submit a proposal to the Society that a Welfare Services Group should be established, in addition to the Mental Health and Teaching Groups now being formed. This action was approved. In opening a discussion on the Report of the Health Visitors' Working Party, Dr. J. F. Warin, medical officer of health, Oxford, thanked the Branch for giving him the opportunity of returning to Birmingham and of speaking to former colleagues and friends about the Report of this Working Party of which he had been a member. The Party had arrived at a unanimous finding, due to the qualities of the chairman and vice-chairman, and to the mutual give and take which had been a feature of the two years' work. A close working relationship between general practitioner and medical officer of health had been accepted as essential at the outset. Members of the Steering Committee had been called upon from time to time, but that Committee had only met on two occasions, at the beginning, and, at the end, to receive the final Report. The true value resulting from the two years' work lay, in his opinion, not in the Report but rather in the thought given in the preparation and submission of evidence. Dr. Warin referred to the health visitor as the Family Visitor and the only general purposes social worker, although her first care would always be " mother and child " ! Specialisation was warranted only in special circumstances, perhaps on a part-time basis, while the combined worker should always be a qualified health visitor. He preferred the family nurse combining health visitor and district nurse functions as the general practitioner's right hand man, unencumbered by the urgent midwifery call, to any scheme where all three functions were combined. Her status must be enhanced and, there was no doubt, the more a general practitioner knew of her work, the more appreciative was he of the help she could give. There must be regular contact also with hospital Almoners and ward sisters. There should also be the fullest co-operation with midwives, home nurses and social workers. On the question of training, Dr. Warin drew attention to the Report of the Nurse Training Working Party, with a plea for integration of the training of the
40
PUBLIC HEALTH VOL. LXXI NO. 1
general nurse, midwife and H.V., and in his closing remarks, spoke of the serious manpower situation and hoped that some effort would be made to interest schoolleavers in the possibilities of health visiting as a career and to inform hospital nurses of the work and opportunities available. Dr. J. F. Galloway, and Drs. Tabbush, Pickup, Griffin, Findlay and Milligan, contributed to the discussion and a cordial vote of thanks was accorded to Dr. Warin on the proposal of Dr. B. M. Thompson, seconded by Dr. Hatherley.
Correction--We regret that owing to an unfortunate error our obituary notice last month recorded the date of Dr. W. G. Clark's qualification in medicine as 1918. This should, of course, have been 1910 for, in fact, Dr. Clark served throughout the First World War in the Royal Navy.
BACK NUMBERS OF PUBLIC HEALTH
REQUIRED
The medical secretary requests the return by any members of the Society who do not wish to retain them of copies of Public Health issues of April and August, 1956, and January and February, 1957, which are needed to complete orders for overseas libraries. Postage will be refunded.