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The year 1947 saw Great Britain involved in an outbreak of Acute Anterior Poliomyelitis more extensive than any previously experienced. In England and "Tale there were 7,800 cases of poliomyelitis and polio - encephalitis notified. This gives a rate of 18 cases per 100,000 of the population, whereas the previous greatest incidence was 4 cases per 100,000 in 1938. In Scotland, the outbreak was of similar severity. Notifications numbered 1,698, of which 1,434 were confirmed, equal to a rate of 28 per 100,000 compared with the previous highest of 5.6 per 100,000 in 1928. Some localities were heavily involved, while their neighbours were hardly affected. The Combined County of Moray and Nairn was one of the former, having, in 1947, over 50 cases in a population numbering between 150,000 and 60,000, approximating to a case incidence of 100 per 100,000. Its neighbours, Banffshire and Inverness shire, with essentially similar populations, were relatively unaffected, the former having 2 cases, and the latter 15, while the large Burgh of Inverness, with rather less than half the population, had no cases at all. The study now presented finds its justification in the extraordinary local intensity of the outbreak. The study commences with a general description of the disease. This description follows orthodox lines, and is influenced by the writings of many others, in general text -books and in papers dealing with particular aspects of the subject. The main headings of the description are listed below: Historical Survey | Aetiology, and Epidemiology | Pathology | Clinical Features Diagnosis and Differential Diagnosis | Treatment | Prognosis | Prophylaxis After the preliminary survey of the present state of our knowledge of the disease, the outbreak in Moray and Nairn will be described under the following headings. Occurrence of Poliomyelitis in the World 1939 -1946 | History of Poliomyelitis in Great Britain - Relationship to Leteorological Conditions. | Meteorological Conditions 1946 -1947. | Outbreak in 1947: Onset - location. - weather in locality of onset; Rise - spread to the various parts of the country. | Decline. | Scotland in Relation to England and Wales. | Moray and Nairn in Relation to Scotland: 1. Previous experience. 2. Weather. 3. Time relationship. 4. Clinical material. (a) Number and nature of cases. (b) Symptomatology. (c) Comparison with other series. (d) Diagnosis and Differential Diagnosis. (e) Treatment and its results. | 5. Epidemiology. (a) General Picture. (b) Cases in the Burgh of Rothes and environs (c) Cases in the Burgh of Elgin and environs (d) Cases in the Burgh of Forres and environs (e) Cases in the Burgh of Lossiemouth and environs (f) Isolated Cases. (g) Areas not affected. (h) Cases in 1948: i. Location. ii. Nature, with special reference to vertigo. iii. Relation to weather. (j) Lines of infection leading to Moray and Nairn. (k) Multiple cases. (l) Infectivity of cases. (m) Fatigue and travel in relation to morbidity. | 6. Preventive measures. | Discussion. |
