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102
While this affords reason for satisfaction to all who have
worked unremittingly to bring about the elimination of diphtheria
it must again be emphasised that there is an inherent danger in that
freedom from this disease may lead to apathy towards immunisation,
which, in turn, could give rise to a recrudescence.
In his Circular 8/53 inaugurating a special Diphtheria Publicity
Campaign the Minister of Health stated that it cannot be said too
often by Medical Officers of Health in their Annual Reports and in
public utterances that " diphtheria still kills " and that elimination
is conditional upon the maintenance of an adequate level of immunisation.
A satisfactory level is only to be secured by the persuading
of each generation of new mothers of the necessity of immunisation
and great as the effect may be of advertisements, posters, cinema
slides, etc., it is the sustained effort of personal persuasion by
doctors, health visitors, sanitary inspectors and other welfare
workers which is likely to prove most successful.
Complete immunisations in the Borough during the current
year numbered 904. This is an increase of 15 over the figure for
1953 but 175 less than that for 1952.
Only 176 cases of diphtheria were notified throughout England
and Wales during the year and as the Minister of Health has shown
some concern over the question of the incidence of diphtheria and
the fall in immunisations effected, investigation was made into
sporadic cases.
In connection with the Greenwich case, which was of anterior
nasal type in an immunised child of 9 years, C. Diphtheria miiia was
isolated but this was avirulent by the Elik plate test. Guinea pig
inoculation, however, gave the reaction of a weakly virulent strain.
The remainder of the family and all his school contacts were swabbed
with negative results.
On request, this information was forwarded to the Ministry of
Health.
Antitoxin.—Since January 1949 a small stock of Diphtheria
Antitoxin has been held at St. Alfege's Hospital for use by General
Practitioners in emergencies.
Acute Primary Pneumonia and Acute Influenzal
Pneumonia.—There were 16 cases attributed to these causes as
compared with 18 and 23 for 1952 and 1953 respectively. Seven
occurred in East Greenwich ; 1 in St. Nicholas, Deptford and 8 in
(Carlton and Kidbrooke. There was one death—a man of 69 years.