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94
also frequent among well-nourished children living under satisfactory
housing conditions.
Immunisation.
Owing to a small outbreak of Scarlet Fever at Bartrams School
in which 16 cases occurred amongst the 216 scholars, it was decided
that immunisation should be offered to the school authorities.
There were 48 acceptances for preliminary Dick testing, of whom
10 were over 14 years of age and 38 under. Three of the adults and
14 of the children showed positive reactions (i.e., 35 per cent.), and
these were all subsequently immunised by Dr. C. R. Lane. The low
percentage of positive reactors is doubtless accounted for in that many
had been spontaneously immunised in the outbreak immediately
preceding.
Dr. Lane reported that there was no reaction of any kind in any
of the patients. No further case of Scarlet Fever has occurred at the
school.
Burroughs Wellcome material was used; the course of immunising
adopted and the results obtained were as follows : —
The first course consisted of four injections at fortnightly
intervals. The injections given were 500A, 1000A, 5000C and
20000C skin test doses respectively. Four weeks after the fourth
injection the individuals were again Dick tested and it was found
that one adult and 8 children were still positive (i.e., 50 per cent.).
The positive reactors were then given a further injection of
20000C skin test doses; another Dick test performed three months
after the completion of the first course showed no positive cases.
It will be noted that the doses of toxin used were small as compared
with what the Dicks are now recommending, but they were
much the same as used by Benson in Edinburgh with excellent results
some years ago.