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and to a proper conception of the value of the facilities provided
by the Local Authority whereby such immunity can be secured.
It is very satisfactory to note that diphtheria prevention
treatment is rapidly gaining ground, notwithstanding an active
campaign against it.
Our aim must be centred in trying to persuade parents to
have their children treated as soon after they reach the age of
6 months as possible; in any case before they are due to attend
school, so that immunity may be secured during a period of years
when they are most susceptible to diphtheria.
Unfortunately it is difficult to get parents to appreciate the
importance of immunisation at an early age, and this can only be
surmounted by constantly directing attention to the severity of
the mortality from diphtheria amongst pre-school children.
Diphtheria prevention treatment was started by this Council
at the end of 1926 at the Municipal Infant Welfare Centre, 140,
Camberwell Road. Clinics are held every Wednesday afternoon
and on Saturday mornings when required.
During 1927, 472 persons were Schick tested, and of these
240 were successfully immunised.
The routine procedure carried out at the Clinic is as follows:
Children are admitted separately with parents or in families, and
on receiving the necessary authority are Schick tested, and instructed
to return to the Clinic the following week in order to
ascertain the result of the test. Positive Schick reactors then
receive an immunisation injection, which is followed by two
further inoculations at intervals of one week from the first and
two weeks following the second inoculation.
Patients are then requested to report again at the end of
3 months for the purpose of receiving a further Schick test.
Generally speaking, this test shows that three protective
injections successfully produce immunity, but occasionally it is
found necessary to administer one, two, or even three additional
injections before an immunity certificate can be issued.
The success or otherwise of the arrangements provided for
securing artificial immunity depends to a great extent on the
personality of the operator. The necessity for him to make
friends with his young patients cannot be over-stated. A few
minutes tactfully spent at the beginning of the treatment will
enable him to carry out the procedure successfully on a child
who would otherwise probably refuse to come a second time.
In stating this view one must not, of course, lose sight of the
interest and patience which have to be shown by those who make
use of the facilities, particularly in view of the fact that at least
five visits are necessary at the Clinic before immunity can
generally be secured.