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77
Up to the end of December 59 nurses were tested; 31 were found positive and
24 of these were immunised. At the London Homoeopathic Hospital at the time
of starting the work attendance for testing and subsequent immunisation was
voluntary, but the results of immunisation have been so satisfactory that Schick
testing of all newcomers and immunisation of positives, is now compulsory. Four
of the seven nurses who were found positive but refused immunisation have since
then left the hospital. The 59 nurses referred to above are included in tlx' total
tested as given in Table II, page 70.
Some of the nurses at the Hospital for Sick Children, Great Ormond Street,
are immunised against diphtheria by the hospital staff.
Diphtheria Immunisation is Worthy of an Extensive Trial.
It should be pointed out that the results obtained in Holborn from antidiphtheria
immunisation are not necessarily those which would be obtained from
the widespread practice of the procedure throughout the whole of the country. It
is a commonplace in the public health world that satisfactory statistics cannot be
compiled from a relatively small number of cases.
If we are to reduce the incidence of diphtheria further we are to
all intents and purposes forced to employ a method of this nature
and for this reason. Diphtheria is a very difficult disease to control;
it is spread mainly by healthy "carriers," that is to say, by healthy persons who
harbour virulent diphtheria bacteria chiefly in their throats or noses or both, these
bacilli are often passed on during the act of coughing or even loud speaking, or perhaps
for a very short distance by ordinary breathing, especially in the case of overcrowded
vehicles or passenger lifts, or by means of incompletely cleansed drinking
vessels or eating utensils placed in the mouth such as spoons, forks, etc.
Diphtheria immunisation is worthy of an extensive trial. The procedure
has already gained wide acceptance in the United States of America; other
countries nearer home, such as Germany, France and Belgium are immunising
their children in this way. In these islands it has proved its worth as a means
of preventing diphtheria in hospital nurses and in stamping out diphtheria in
institutions where the disease has been present for a considerable time and has
given rise to case after case. The Edinburgh statistics relating to school children
are, to say the least, very encouraging. The control of smallpox obtained by
vaccination is so complete that progressive members of the medical profession
have been stimulated to obtain a similar control of other infectious diseases
including not only diphtheria, but also scarlet fever and measles, and the measure
of success already obtained in controlling diphtheria warrants further effort,