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In addition, one child re-Schick tested 15 months after 1 c.cm. T.A.T., was
found positive, and two children retested after 3 c.cm. were on the information
given by the mother considered to be slightly positive. Fifty-three of those positive
on re-Schicking have been further inoculated, and 28 of them further tested and
found negative. Efforts are being made to continue the inoculation of the
remainder; in addition, two others, found positive to the second re-Schick. after
4 c.cm. have been further inoculated, and are awaiting a retest. As seen in the
footnote to Table V. one child (F., aged 4 years) was positive to the second
re-Schick after 6 c.cm., but was negative after 8 c.cm.; this child was the eldest
of four girls; the three younger ones were negative after the routine 3 c.cm.; two
of these receiving their routine injections on the same day and from the same
batch of toxoid antitoxin as the eldest.
Of the 482 persons retested, 217 were males and 265 were females.
Among the positive were 26 males and 38 females. Neither age nor interval
seems to have any influence on the phenomenon. It would seem conceivable that
some batches of toxin antitoxin or toxoid antitoxin might prove to be less
efficacious than others. An analysis of the results obtained in Holborn would
seem to indicate clearly that this is so; also that the toxoid antitoxin used was as
efficacious as the toxin antitoxin. The toxin antitoxin used were all 3 L + per c.c.m
mixtures, the toxoid antitoxin contained toxoid diluted 1-10 with added antitoxin.
(Table VI.)
That considerable importance attaches to the retesting is shown by the fact
that cur four cases of diphtheria among those treated occurred in children who were
given the routine three injections, but had not been retested.
The first case was a boy (aged 4) who suffered from a severe attack of the
disease, but recovered without any complications or sequela; his recovery was
ascribed certainly by his mother to the inoculations of T.A.T. given after Schick
testing.
A second case is said to have occurred in a boy (aged 8) also given the routine three
injections. Two years later he was diagnosed (for the third time in his life) as suffering
from diphtheria ; no swab was taken. On admission to the M.A.B. Hospital he was first
found to be swab negative, later swab positive, but was diagnosed as a ease of
diphtheria. The mother fortunately is still convinced that the boy did not suffer from
diphtheria.
A third child (a girl, aged 3) had a mild attack, and made a good recovery;
in the fourth case (a girl, aged 6) a severe attack occurred four weeks after the
last of the routine three injections had been given. It will be seen from Table V.
that the length of the period before immunity is acquired varies considerably.