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66
IMMUNIZATION AGAINST DIPHTHERIA.
Dr. J. Tudor Lewis, one of the whole-time Assistant Medical
Officers of Health, has been in charge of this branch of Preventive
work, and 1 am indebted to him for the details given below.
The routine methods in use in the Immunization Clinic, which
have been fully described in previous reports, remained, except fori
one modification, unchanged in 1938. The small outbreaks of
Diphtheria in Kingsley, Waddon and Duppas Schools in the latter
months of 1937 and early 1938 was followed, as is usual, by a rush
to gain protection against the disease, and clinics were opened at
Kingsley and Duppas Schools. During the summer months,
coincidently with a drop in the Diphtheria notifications, was a
diminution in the number of applications for Immunization, and
the Clinic usually held at Selhurst Road was closed, to be opened
again later in the year.
The modification referred to aibove was the introduction of
Alum precipitated toxoid, in a dosage, initially, of 0.1 cc., followed
in a fortnight by 0.5 cos., and later on of 0.25 cos., followed in
one month by 0.5 ocs. Up to the end of 1938 some 200 cases had
completed treatment by this method, and only one of them had
been found to be still Schick positive. There is little doubt that
this preparation, when given by two injections, is a much better
antigen than those previously used. The liability to serious reactions
is very little greater than with T.A.M., and by giving 0.25 ccs. as
a first injection, those children who are sensitive to the compound
can be eliminated. A.P.T. administered by the above technique is
now in routine use. Investigations are at present being conducted
of the data which has been collected during the period that the
Immunization scheme has been working, with a view to determining
the most efficient and economic procedure for use in antiDiphtheria
Immunization Schemes.
The Work For The Year.
On January 1st, 1938, 511 were under treatment; of these 461
completed a course of T.A.M., 6 of T.A.F., 41 of A.P.T., and 6
defaulted.
Tn 1938 1,541 new cases attended, 1,208 being given a Primary
Schick Test, while 353 commenced treatment without any test.
The new cases were derived from the following sources:—
School cases 1,179
Infant Welfare cases 130
Others under 5 years 232
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