Streptomycin in Infantile Gastro-enteritis

Abstract

I realize to be very limited, has been to associate the disease with a favourable social grading. I find on discussion with colleagues that they also feel that there is a social class distribution in relation to poliomyelitis which is quite different from that of other infectious diseases, and I would like to suggest that a second survey to prove or disprove this contention should be conducted. Simply with the idea of stimulating interest in this direction I gathered case histories of twenty-one consecutive cases which have come under my observation and placed them into social classes according to the occupation of the principal wage earner of the family. The result was as follows: Class 1, 3 cases Class 2, 5 cases; Class 3, 7 cases; Class 4, 4 cases; and Class 5, no cases. The remaining two were a student at a primary school training college and an infant in a county council children's home. If the above suggestion was supported by an observation on a sample of sufficient size to permit of statistically accurate deductions being made it would provide interesting material for speculation. Apart from complex associations which might be brought forward, there is a simple fact that during the period when poliomyelitis is epidemic there is a much greater amount of travel among families with larger incomes. This in turn could be an effective factor in either of two directions. In the first place it could be an application of the conclusion reached by Ritchie Russell' on the effect of prolonged fatigue as a predisposing factor. In the second place it could help to explain the peculiar way in which cases occur during an epidemic. These generally start with foci in a few areas and are followed by sporadic cases in many different areas. If more accurate social histories were taken from all cases occurring durpg an epidemic year and the lines of travel of the affected persons in widely separated areas in the country correlated, it might be found that the apparent sporadic occurrence of cases was to a large extent mythical, and that explosive outbreaks are occurring-the cause being disseminated by victims who are passing through a long and symptomless incubation period. This would surely present a more reasonable picture of a disease which reaches its height in the middle of a hot, dry summer and is practically unknown in January.I am, etc.,