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The parents of persistent carriers are advised to obtain treatment for the
children concerned and are recommended to take such contacts to St. Mary's
Hospital for treatment by inoculation with vaccine made from the patient's own
germs; one case was so treated last year.
In the case of five other persistent carriers tests for virulence were made; all
these were found to be avirulent.
The parents or others in charge of children harbouring diphtheria bacilli were
given written directions as to the precautions necessary.
The results of the examinations of child contacts were communicated to the
School Medical Department of the London County Council so that children
harbouring diphtheria bacilli could be kept from school providing there were no
evidence that the organisms were avirulent.
Diphtheria antitoxin was supplied free of charge on application by medical
practitioners. During the year it was supplied in 16 cases. In accordance with
present views as to the dose required the antitoxin is stocked in phials containing
8,000 units, the minimum quantity usually required for a patient, and 500 units,
for use, as phophylactic doses of temporary value for contacts. The usual dose for
this purpose being 500 to 1,000 units. It has been so clearly shown that the earlier
antitoxin is given in the disease the better is the chance of recovery that every
advantage should be taken of this fact; a possible source of; delay in administering
antitoxin is if the doctor sees a patient and after examination he suspects that
he is dealing with a case of diphtheria he merely takes a swab for bacteriological
examination and does not inject antitoxin at once, but delays till he hears the
result of the bacteriological examination some 24 hours or so later. This source
of delay is so important that it has been suggested that Public Health