London's Pulse: Medical Officer of Health reports 1848-1972

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Hampstead 1938

[Report of the Medical Officer of Health for Hampstead Borough]

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During the year 296 children were immunised against Diphtheria;
116 by private doctors, and 180 by the Council's Assistant Medical
Officer. Of these
(a) 132 were pre-school children.
(b) 164 were school children.
126 Schick tests were performed. There was no preliminary
Schick testing in children below 8 years of age.
Diphtheria Toxoid Anti-Toxin (Goat) is used for immunisation;
three injections of 1 c.c. at weekly intervals are given.
Alleged Diphtheria in an immunised child.
A boy aged 5 was given three injections of diphtheria toxoid antitoxin
in July, and in December he was notified as a case of Diphtheria.
The Medical Superintendent of the Fever Hospital stated that he was
admitted a week after the onset of a sore throat for which he was
given anti-toxin by the attending practitioner. On admission there was
no evidence of disease but virulent Diphtheria bacilli were found in
the throat and nose. The Medical Superintendent reports that a provisional
diagnosis of tonsillar diphtheria was made, but that it is
possible that the patient suffered from tonsillitis and was at the same
time a diphtheria carrier. A routine Schick test was not performed
in this case. The child first attended the Immunising Clinic in January
but did not attend for the second dose until July when two further
injections were given. Although requested to come again for a fourth
injection his parents did not bring him.
It should again be emphasised that even should diphtheria occur
in an immunised subject, the disease usually runs a mild course.
It is probable, however, that many such cases are not due to true
diphtheria, but are cases of tonsillitis in diphtheria carriers.
Diphtheria Anti-Toxin (London) Order, 1910.
In accordance with this Order the Borough Council supplies antitoxin
free to medical practitioners for use for the poorer inhabitants
of the Borough.