View report page

58
In view of the satisfactory results obtained by R. A. O'Brien in the Holborn
(Poor-law) schools, arrangements were made in 1922 to render the measure
available for the general child population of Holborn. The results obtained are
summarised in Tables I., II., and III.
The results of the Schick testing were very much the same as those found
in all other urban areas; we have, however, analysed them in connection with the
immunity to diphtheria of various members of the families dealt with. The last
column in Table IV. shows the number of exceptions (11.5 per cent.) to the
expectation that positive reactions will be manifested only in the younger
members.

In one family of five children, twins (F.) of 2-3 years of age were both
positive; of twins of 7-8 years, one (M.) was positive, the other (F.) was negative.
In one family of three children one twin (M.) was negative, the other (F.)
was positive; the latter had already been in hospital with diphtheria.
In one family of four, all Schick positive to the first test, two members were
found to be Schick positive to the second test. The first of these (F. 4) was
immunised some months previously to the second one (M.1), and was further
inoculated, being negative to the second test; the second child is not yet retested.
In another family, twins, one male aged 2 years when tested and one female
aged 5 years when tested were both Schick positive.
Routine Procedure.
The routine of the procedure carried out is as follows. The child is Schick
tested at the Council's Maternity and Child "Welfare Centre, and if susceptible to
diphtheria is brought up by the parent at weekly intervals for the next three weeks
for immunisation, and then at the end of another three months (formerly we tried
for the period six to eight weeks) for re-Schick testing, when, if it happens to be
still positive, it receives further inoculation. A modification of the routine occurs
if from the Schick test it is seen that the child is particularly susceptible to
protein reactions; in this case the 3 c.cm. of toxin antitoxin mixture are given in
four or five doses at weekly intervals
Some difficulty has been experienced in securing the necessary number of immunising
injections owing to the children belonging to families who remove from the district; some
of these however attend to finish the course. A few adolescents at times fail to complete
the course by reason of being employed and it no longer being convenient for them to
attend.