Please Send Notifications, Nil Returns, and Later, All Clinical Reports to Dr
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Epidemic Observation Unit Epidemic Winter Vomiting The following "Red" Warning was circulated with News- letter No. 5. Epidemic Winter Vomiting This disease appears to be widely prevalent in the South East of England and may be so elsewhere. The clinical picture in one practice is as follows: 1. Sudden onset of vomiting, often in the night. 2. Repeated at short intervals for 2-6 hours. 3. Affecting mainly children but also adults of any age, more women than men. 4. Sometimes accompanied by diarrhoea. 5. In a few cases there may be concurrent sudden high fever but little or no vomiting. Most cases are afebrile. 6. Headache may be marked. 7. Abdominal pain may occur with vomiting in older children or adults. 8. Children recover quickly but adults may feel ill for a further 24 hours. 9. Cases appear to be infectious for as long as 12 hours before vomiting. 10. Secondary cases follow in 48 hours or less. It is felt that an attempt should be made to determine the distribution and spread of this condition and each member is asked to record the date on which the earliest cases appeared in his practice. It is realised that the doctor may not be called in to see these cases, but it may nevertheless be possible to determine the date of first appearance in a district by local inquiry. It is requested that information, in the words of the noti- fication attached should be sent in as soon as possible. Details of localities affected will be entered on a map prepared for the purpose. JVil returns, dated, are important in this type of work, and where applicable these should be sent in immediately. Notes and records of the age incidence, infectious period, incubation period, serial interval, mode of spread or other obser- vations of epidemiological interest should be sent in later when they are complete. Please send notifications, nil returns, and later, all clinical reports to Dr. G. I. Watson, Corran, Peaslake, Guildford, Surrey. 23 SECOND INTERIM REPORT on the distribution of Epidemic Winter Vomiting as reported up to week ending 1st Jan. 1955. RESULTS Total positive returns ... ... 97 Total nil returns ... ... 50 (It may be presumed, without cer- tainty, that a majority of those who have not reported as yet have seen no outbreaks of this condition.) In Table I the dates on which the earliest cases were seen by each doctor are grouped together by weeks. In Table II the list is given of the Counties in which those doctors live from whom nil returns have been received. TABLE I Dates on which earliest cases were seen and area of the doctor's practice. 1954 July London, Devonport, Lincoln. 18-25 Sept. Cheshire. 26 Sept.-I Oct. Surrey (2), Birmingham. 2-9 Oct. London (2), Essex, Yorks. 10- 16 Oct. London, Surrey, Essex, Staffs., Cumberland. 17-23 Oct. Essex (3), Surrey, Sussex, Yorks. 24-30 Oct. Essex (2), Kent, Glos. 31 Oct.-6 Nov. Essex, Surrey, Herts, Kent (2), Hants (2), Oxford, Birmingham, Yorks. 7-13 Nov. Essex, Herts (3), Surrey (2), Kent, Sussex (2), Hants (3), Worcester, Leicester, Birmingham, Lincs., Yorks. (2), Wales, Ireland. 14-20 Nov. London (3), Middlesex, Essex, Suffolk, Surrey (3), Kent (4), Sussex (2), Hants., Somerset, Bucks., Worcester, Birmingham (2), Hereford, Staffs., Shropshire, Cheshire, Lancs., Yorks. (2), Edinburgh. 21-27 Nov. Warwick, Cheshire, Lincs. 28 Nov.-4 Dec. Kent, Hants., Norfolk. 5-12 Dec. Surrey, Hants., Devon, Durham. TABLE II NIL RETURNS have been received from doctors in the following places: London (5), Middlesex, Surrey, Kent (3), Devon (3), Dorset, Somerset, Wilts., Oxford, Bedfordshire, Warwickshire, Glos., Leicester, Birmingham (2), Derby (2), Cheshire (2), Lancs. (2), Yorks. (7), Lincs., Co. Durham, Cumberland, Glasgow, Perth (2), Kincardineshire, Inverness, South Wales (3), West Wales. 24 In the first interim report up to week ending 4th December, it was suggested that the disease had been occurring sporadically during the summer and that from the beginning of October it became epidemic in parts of South East England, particularly in the counties around London; and that from the beginning of November the epidemic began to spread towards the north and west into the Midlands, Lancashire and Yorkshire. The results which have come in since the beginning ofDecember have amplified but not altered the original picture. It would seem that this disease became widely prevalent during November, as mentioned above, but that during December only a few fresh areas were affected. It was noted in the first interim report that several doctors had mentioned that the duration of the epidemic in their practice area was only a few weeks. Since then others have reported likewise. There have also been one or two reports about a subse- quent prevalence of typical influenza-like illness in practices where E.W.V. had previously occurred. If any one has records of indi- viduals who were affected by typical attacks of both E.W.V. and subsequently influenza, I would be glad to receive a report about them. Paired blood samples have been taken from a few typical cases of E.W.V. but the serological reports on these are not yet available. A further report about the outbreak will be made later. G. I. WATSON, Director, Epidemic Observation Unit. 4th January, 1955. News from the Faculties South West Faculty A RESEARCH ADVISORY PANEL has been formed, and Dr. M. G. P. Stoker, of Glare College, Cambridge, has been invited to serve along with Dr. Gale and Professor Milnes Walker. A Faculty Research Committee has been set up consisting of Drs. M. I. Cookson, E. B. Hickson and A. E. de la T. Mallett, and they have been given power to co-opt three other members. The Obstetric Survey is well started, and those members who are taking part are thanked for their help, and reminded that cards should be forwarded regularly. (Newsletter to Members, 27th Oct., 1954.) 25.