Clinical and Chemical Studies in Human Lactation--VI

CHILDHOODMEDICBALJOAL on outdated material it is not likely that any borough has moved from one extreme to the other in social grading.The trend of the incidence of measles in both these groups of boroughs was very similar, and there was no difference of any importance between them.A summary of their positions is given in Table III.It appears from these values that the relative incidence of measles was constant during the period, although Group 1 had relatively a larger outbreak than Group 2 in 1950 owing to a summer rise in incidence.The introduction of the National Health Service in 1948 did not have any differential effect on the incidence.In recent years the measles attack rate has been twice as large among pre-school children as among schoolchildren, and the ratio of these attack rates has been practically constant during the past nine years. SummaryThe number of notifications of scarlet fever, whooping-cough, and measles rose in the six months preceding the operation of the National Health Ser- vice in 1948 and has remained above the level prevailing in 1946-7.Scarlet Fever.-Although the incidence in the first quarter of 1948 was unusually high the subsequent level of the notifications does not suggest that the prevalence of scarlet fever has undergone much change in recent years.There is, however, a suggestion that since 1948 the disease has tended to be more concentrated on the pre-school child.Whooping-cough.-A large increase in the numbers of notifications has occurred since 1948.If the prewar estimate that 70% of the child population have an attack of whooping-cough before age 15 is still valid, then only about one-half of the cases are being notified.But if immunization against whooping-cough has been carried out on large enough numbers it is possible that the higher level of notifications since 1948 is due to a real increase in prevalence.Measles.-The level of notifications of measles has increased in recent years.The whole of the rise in 1948 cannot be explained by increased case-finding and reporting, and it seems that there was a real rise in prevalence just before the operation of the National Health Service.The proportion of children under 15 who suffer a notifi- able attack of measles has risen from about one-half in the early 1940's to about two-thirds in the last five years.It seems probable that there has been a real increase in prevalence during these years.