public health

514

wages and full employment in the lower income-groupsof producing countries.

In 1945 many European countries made plans to buildup their greatly depleted livestock populations, andcoarse grains, such as barley, were turned over fromhuman consumption to animal feeding. The extraction-rates of flour for bread-making were also lowered, partlyto produce more offals for animals, and though these ratesare now being raised again too much grain is still beingfed to livestock, considering human needs. For the most’economical way to use grain is to feed human beingsdirect-it needs 3t lb. of grain and concentrated feeding-stuffs to produce 1 lb. of beef ; 5t lb. to produce 1 ’lb.of eggs ; and 0-7 z lb. to produce 1-lb. of pig meat.

Consumption Levels.-The present food consumptionof the civilian population in countries for which fairlyreliable statistics are available is estimated as follows:

.

4t’. daily con-Country sumpt-ion (calories % of

per head) pre-warUnited States ...... 3150 .. 102Canada 3000 .. 100Australia.. ’2900 .. 97Denmark, Sweden .... 2850-2900 .. 90-95United Kingdom .... 2850 .. 95France, Belgium, Holland, Nor- 2300-2500 .. 75-80way, Greece, Jugoslavia j OO-oOO .. 75-SO

Czechoslovakia, Italy.... 1800-2200 .. 70-75Germany, Austria .. , 1600-1800 .. 50-60

These figures take no account of the fall in quality ofthe diet—e.g., in the United Kingdom 45% of the calorieintake now comes from grain and potatoes, against 34%before-the war. Many people, especially in towns, receivemuch less than the average : thus the average consump-tion of the non-farming population is estimated as

1800-2300 in France and Belgium ; 1400-1800 in theUNRRA countries ; and 1200-1400 in the ex-enemycountries. Even these figures conceal the effect ofdifferential rationing and varying availability of supplies.Many people who have no priority for rations and littleaccess to unrationed or black-market foods are

undoubtedly approaching starvation levels, and furtherreductions in rations will be inevitable as the full impactof the grain shortage is felt.

Outlook for 1946-47.-The present difficulties are

unlikely to disappear with the next harvest. Someincrease in production may be expected in the former warzones, and this season’s droughts are unlikely to recur,but exportable supplies will fall heavily with the virtualexhaustion of stocks accumulated during the war. Goodcrops and a large exportable surplus in the U.S.S.R.might bring considerable relief, but no precise estimateof their supply position in 1946-47 is yet possible.

STOCKS AND REQUIREMENTSBread Grains.-Allowing’ for the maximum practicable

reduction in stocks and some reduction in animal feeding,exportable supplies from the grain-exporting countries in1945-46 are estimated at 23-7 million tons-about twice theaverage pre-war figure-and total world import requirementsat about 32 million tons. The world deficit of wheat for theyear is thus about 8 million tons., Rice.-Supplies are entirely inadequate to meet the needsof Eastern countries where rice is the staple food. Produc-tion in Burma, Siam, and French Indo-China, the main

exporting countries, fell drastically under Japanese occupa-tion : before the war they exported 6 million tons annually,whereas the present crops are barely sufficient for domesticneeds. Similarly in China production has fallen by 17% andin Japan by 20% of the pre-war average. In India badweather has offset the effect of increased acreage ; the cropthis year is unlikely to exceed 25 million tons-a million tonsless than the pre-war average. Total export supplies for1946 are estimated at 2-4 million tons, against import require-ments of 5-5 million tons. It will take more than one season

-perhaps 4 years in Burma-to restore world production.Meat.-Future supplies of meat will depend mainly on this

year’s grain harvest. If this fails the amount of grain fed tolivestock will have to be reduced in’all countries. This maypostpone the recovery of livestock in Europe and reduceproduction in North America. There is little hope of sub-stantially increased production in South America, Australia,or New Zealand -to offset this decline, so that world suppliesare likely to continue short of requirements for some time.

Oils and Fats.-World exports in 1946 will be about halfthe pre-war level, and total supplies in importing countriesabout 80% of normal. No substantial improvement can beexpected until Far Eastern exports of oilseeds and vegetableoils approach the pre-war scale.Sugar.-1946 may prove to be the low point for sugar sup-

plies. An increase in European production may be expectedat the end of 1946, and$mall exports may be obtainable fromthe Far East in 1947.

STEPS TO MEET THE CRISIS

With the end of the war the United Kingdom ceasedto be a bastion into which Allied nations were eager topour supplies and now had to share its claims with vastliberated areas, some of them within the Empire. Withthe suspension of Lend Lease and Mutual Aid, too,currency problems again became an urgent factor indetermining our food imports. Since the United King-dom is a large importer of food, the Government’s effortsto ameliorate world shortages must be limited to securingthe best use of land in this country, of the products ofthat land, and of all imported food and animal feeding-stuffs.The maintenance of wartime controls, though irksome,

has minimised our dependence on imported supplies,and the Government has played an active part in direct-ing available supplies to areas where they are mostneeded.

Public Health

SmallpoxTHERE have been one certain and one possible case

of smallpox at Southend-on-Sea. A girl of 20 years,taken ill on March 16, died on the 28th and was foundafter death to have had a typical confluent smallpox.She had not been seen by a doctor owing to religiousscruples, and had not been vaccinated. The girl visitedStanford-Ie-Hope early in March, and there had beensmallpox in that area, but no contact with an infectedperson could be established. She worked in a laundry,but there was no evidence that she had handled infectedlinen. Her mother, who nursed her during her illness,has what seems to be a mild attack ; she was vaccinatedin infancy.A woman from New Ferry, Cheshire, was admitted

to Clatterbridge General Hospital on March 25, havingdeveloped a rash on the 22nd. Smallpox, modified byvaccination, was diagnosed on the 30th. It seems pos-sible that she was infected by a soldier son-in-law homeon leave, who had an undiagnosed rash.

"

Milk and Meals for SchoolchildrenMiss Ellen Wilkinson, Minister of Education, announced,

in the House of Commons on March 28 -that the Govern-ment have decided to make school milk free of chargein all grant-aided primary and secondary schools fromthe date of the introduction of cash family allowancesin August next. Dinners in these schools are also to bemade free of charge as soon as canteen facilities sufficefor the expected demand.

Infectious Disease in England and WalesWEEK ENDED MARCH 23

Notifications.-Infectious disease : smallpox, 0 ; scarletfever, 1325 ; whooping-cough, 2190 =; diphtheria, 417;paratyphoid, 4 ; typhoid, 6 ; measles (excluding rubella),1875 ; pneumonia (primary or influenzal), 976 ; cerebro-spinal fever, 67 ; poliomyelitis, 8 ; polio-encephalitis, 1 ;encephalitis lethargica, 0 ; dysentery, 332 ; puerperalpyrexia, 142 ; ophthalmia neonatorum, 67. No case ofcholera or typhus was notified during the week.The number of service and civilian sick in the Infectious Hospitals

of the London County Council on March 20 was 1153. During theprevious week the following cases were admitted : scarlet fever, 70 ;diphtheria, 25 ; measles, 75 ; whooping-cough, 29.Deaths.-In 126 great towns there were no deaths from

enteric fever or scarlet fever, 3 (0) from measles, 6 (0)from whooping-cough, 6 (1) from diphtheria, 55 (7) fromdiarrhoea and enteritis under two years, and 77 (10)from influenza.

The number of stillbirths notified during the week was245 (corresponding to a rate of 29 per thousand totalbirths), including 32 in London.