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* Two of these were notified as diphtheria and removed to hospital. One was a resident in an adjoining Borough
and information was forwarded to the Medical Officer of Health concerned.
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 was no
evidence that the organisms were avirulent. No virulence tests were necessary
in 1925.
Diphtheria antitoxin was supplied free of charge on application by medical
practitioners. During the year it was supplied in nine 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 prophylactic 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 possibla 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 Departments
should refuse to arrange for bacteriological examinations of swabs taken for
diagnosis of diphtheria; while such a proposal is extreme the fact that it has been
made by Medical Officers of Health of long experience emphasises the importance
of making the diagnosis on what is seen in the throat and of injecting antitoxin
straight away in any case in which diphtheria is suspected, a proceeding harmless
(except the patient be a sufferer from spasmodic asthma) if it turns out from a
bacteriological examination that the patient is not suffering from diphtheria.
The Schick Test and Immunisation against Diphtheria.
This work is carried on at the Council's Maternity and Child Welfare Centre,
10, John Street, on Wednesday afternoons.
Enquiries as to the effect of the testing and inoculation on the individual were
made as a routine; we are able to record that any disturbance caused was
negligible.
Information as to the work carried out for four years, ending December, 19.2"',
follows:—