View report page

Carriers. —The routine swabbing of contacts for the discovery
of "carrier" cases is carried out only amongst such families
where the spread of the disease is suspected to be due to a
"carrier." The parents of children found to be harbouring
diphtheria bacilli were advised that such children should be
segregated and treated by their medical practitioners until the
organisms had disappeared. It is not advisable for "carriers"
to be sent to hospital. On the other hand, convalescents from an
attack of clinical diphtheria when found require hospital treatment,
as they harbour virulent organisms, and in the majority of
such cases some pathological condition is present in the child's
nose or throat.
Diphtheria Prevention.
The research work of Dr. Schick has now resulted in
establishing a very definite claim that by a process of artificial
immunisation susceptible persons can be made immune to
diphtheria, and that the protection thus afforded is of long
duration and that the process is free from risk.
In my previous annual reports I have drawn attention to the
severity of diphtheria and the importance of the need for active
measures to combat this disease.
During the year under review I submitted the following
report to the Public Health Committee on the claims of artificial
immunisation, and it is gratifying to report that the neccssary
sanction was obtained, with the approval of the Ministry of
Health, to establish an immunisation clinic at the Municipal
Infant Welfare Centre, 140, Camberwell Road.
DIPHTHERIA IMMUNISATION.
With the discovery of the anti-toxin treatment of diphtheria it was hoped
that the worst phase of the struggle with this disease was at an end.
The timely use of anti-toxin has gone far in reducing the mortality of this
disease, but has not led to a diminution in the number of cases.
Prophylactic inoculation of contacts of cases of diphtheria with anti-toxin
is a highly important measure for conferring temporary immunity, but can obviously
only be used on a small scale and under favourable conditions. Further, the
duration of immunity resulting is short—about three weeks—and it does not render
the carrier non-infectious.
In recent years much research work has been carried out for the purpose of
discovering a method of determining whether a given person is susceptible or
immune, and also for procuring immunisation of the populace against diphtheria
infection.
By a simple and harmless cutaneous test devised by Schick we are now enabled
to determine whether or not a given person's blood contains sufficient anti-toxin
to protect him from an attack of diphtheria.
As the result of testing a large number of persons of different ages it would
appear from published figures that 80 per cent, of infants at birth have a passive
immunity and that this fades during the first month or two after birth, the
immunity gradually decreasing until at 3 years of age only 28 per cent, of children
are immune.