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Cytogenetic analysis was performed on 175 out of the 319 index cases (54 9 %). Of these, there were 161 trisomies (92%), 11 translocations (6 3 %), and three mosaics (17 %). Between 1969 and 1979 four terminations ofpregnancy for Down's syndrome were performed, all for trisomy.Quinquennial age specific incidences for Down's syndrome were calculated for the years

Sixty nine patients with meningococcal disease some of whom presented with a maculopapular rash were entered in a prospective multicentre study. The clinical and laboratory features of children presenting with maculopapular rashes were compared with those of children presenting with typical haemorrhagic rashes. Of the 69 children 26 (38%) developed maculopapular rashes; nine (13%) had a maculopapular rash only, and the remaining 17 had a mixed maculopapular-purpuric rash. Twelve of the 17 (7%) had less than 12 petechiae. Children with maculopapular rashes had significantly higher platelet counts (median 294 compared with 243x 10I), and plasma total haemolytic complement activity (80.5 compared with 65-0 U/mi) and significantly lower Glasgow meningococcal septicaemia prognostic scores (2.5 compared with 5.5) than those with purpuric rashes on admission. There were no significant differences between the groups in mortality, white celi count or absolute neutrophil count on admission, or C reactive protein concentration.Meningococcal disease can present with a maculopapular rash alone but this does not necessarily mean that the disease is less severe.

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dose 54 units/day). All 10 patients had been issued with a further appointment. Three were subsequently admitted as emergencies, and seven returned to the clinic.Eleven patients (eight men, three women; age range 40-71, mean 56) were under the supervision of their general practitioner, who did not know why they had ceased to attend. Seven patients were on a diet, all but one were also receiving tablets. The remaining four were being treated with insulin (mean dose 38 units/day); none were aged under 30 and three were in the range 30-50. Nine patients were issued with a further appointment. Four were contacted through the district nurse, who took blood samples for