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may revive infection. Patients who suffer from
chronic discharges from the nose or ear after Scarlet
Fever should remain under medical observation, and
take all antiseptic precautions to avoid transference
of infection.
Diphtheria.—The incidence of Diphtheria remained
very low. Fourteen cases were notified, and of these
two were institution cases. The case rate was 018
per 1,000 of population, compared with 158 per
1,000 of population for England and Wales. There
was one death of a male adult, but this was more
directly due to an associated Streptococcal infection.
The relatively small number of cases notified is satisfactory,
but it should be understood that a continued
low incidence is usually followed by a higher
susceptibility, and that secure protection for the
future lies in the Artificial Immunisation of children.
No immunised child developed Diphtheria during
the year.
As to prompt use of Antitoxin.—Early diagnosis
and early treatment with Diphtheria Antitoxin are
the safeguards against mortality from Diphtheria.
Medical practitioners should be called to see suspected
cases at the earliest possible moment, and
large initial doses of Antitoxin should be given on
clinical diagnosis and without awaiting for bacteriological
confirmation of the diagnosis.
Artificial Immunisation against Diphtheria.—
There was an increase in the number of children
immunised during the year. The number receiving
three injections was five hundred and sixty-four.
There was a higher acceptance rate at schools where
the facilities provided are becoming increasingly
appreciated by parents and teachers. The number
of voluntary attendances without request varies
directly with the incidence of cases of Diphtheria.
It should be recognised that immunity takes several
weeks to develop effectively after innoculation, and
that inter-epidemic periods should be utilised to
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