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In addition, one child re-Schick tested 15 months after 1 c.cm. T.A.T., was found positive,
and two children retested after 3 c.cm. were on the information given by the mother
considered to be slightly positive. Sixty-seven of those positive on re-Schicking have been
further inoculated, and 45 of them further tested and found negative. Efforts are being
made to continue the inoculation of the remainder One child (F, aged 4 years) was positive
to the second re-Schick after 6 c.cm., but was negative after 8 c.cm.; this child was the
eldest of four girls; the three younger ones were negative after the routine 3 c.cm.; two of
these receiving their routine injections on the same day and from the same batch of antitoxin
as the eldest.
Of the 619 persons retested, 284 were males and 335 were females. Among the positive
were 34 males and 47 females. Neither age nor interval seems to have any influence on the
phenomenon. It would seem conceivable that some batches of toxin antitoxin might prove
to be less efficacious than others. An analysis of the results obtained in Holborn would seem
to indicate clearly that this is so; also that the toxoid antitoxin used was as efficacious as
the toxin antitoxin. The toxin antitoxin mixtures used were all 3 L + per c.cm. mixtures,
the toxoid antitoxin contained toxoid diluted 1-10 with added antitoxin.
Use has also been made of T.A.F. (flocculated toxin-antitoxin) in the case of
23 persons found Schick positive. Of these 23 persons, 22 have been retested;
in five of these the reaction to the first test was so slight that they were recorded
as suitable for immunisation with only one dose, if T.A.T. had been used. 11 of
these (nine children and two adults) were negative to the retest.
Eleven (ten children and one adult) were positive to the re-Schick test; of
these, six were further inoculated with T.A.F. (three of these were negative to the
second re-Schick), five were further inoculated with toxin-antitoxin (two of these
were negative to the retest). The use of T.A.F. has been discontinued for the
time being.
Retesting.
Retesting is unpopular with parents, and the need for it does not help to
increase their confidence in immunisation. Of 619 that have been retested 70
were found to be still Schick positive after three inoculations and eleven after
T.A.F. The facts relating to these are given in Table V.
Diphtheria in Children Treated with Immunising Injections.
Up to the end of the year 1928 eight cases of diphtheria occurred in children
who had been found positive on Schick test and treated with three immunising
injections.
Diphtheria was also notified as having occurred in five other children who
had completed their course of inoculation, but the diagnosis in these cases was
eventually not confirmed. Two of these (brother and sister) were removed to
M.A.B. hospitals as suffering from diphtheria, but they were diagnosed as suffering
from rubella and "carrying" diphtheria bacilli but not as suffering from diphtheria.
Both these children had been found negative to the re-Schick test some time
previously. Two others were removed to M.A.B. hospitals as suffering from
diphtheria,, but were shortly afterwards discharged as not cases; neither had been
re-Schicked since being inoculated; one case after his return from hospital gave a
negative reaction to the re-Schick test. The fifth was notified as suffering from
scarlet fever and diphtheria, but was later diagnosed as suffering from scarlet
fever only.