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Diphtheria.—The incidence of Diphtheria was very
low. Twenty-eight cases were notified and of these
three were institution cases. The case rate was 0 37
per 1,000 of population compared with 149 per 1,000
of population for England and Wales. A sequence of
cases of a virulent type caused a high mortality. The
source of infection of two fatal cases occurring simultaneously
was a nasal carrier. The extremely rapid
development of the illness, the profound toxaemia, and
the poor response to treatment of this type of infection,
make the necessity for the safeguard of immunisation
apparent. One of the cases notified was a child who
had received immunising injections the previous year.
The clinical evidence of infection was slight, toxaemia
was absent, and complete recovery was rapid.
As to the Prompt Use of Anti-toxin.—Early treatment
depends on early diagnosis. Parents should call
their medical practitioner to see cases of suspected
Diphtheria at the earliest possible moment. In severe
cases a large initial dose of Anti-toxin is essential.
Artificial Immunisation against Diphtheria.—The
facilities provided for immunisation continue to be
appreciated. Five hundred and twenty-one children
receive three immunising injections each. Clinics were
arranged at schools and explanatory leaflets and consent
forms distributed to the parents of the younger
children. The acceptance rate remained between 20
and 40 per cent., but the groups of new entrants
approached were slightly smaller and the number of
acceptances correspondingly reduced. The number of
children attending the weekly clinic at the Public Hall
increased and indicated a higher voluntary response.
Propaganda was carried on by Health Visitors and at
the Child Welfare Centres.
The material used was Toxoid-Antitoxin-Floccules
(T.A.F.) given in three doses of 1 c.c. into the upper
arm, and very satisfactory freedom from reaction has
continued. Of eighty-two children submitted to the
Schick Test, after injection eighty were negative and
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