View report page

72
is a commonplace in the public health world that satisfactory statistics cannot be
compiled from a relatively small number of cases.
If we are to reduce the incidence of diphtheria further we are to
all intents and purposes forced to employ a method of this nature
and for this reason. Diphtheria is a very difficult disease to control;
it is spread mainly by healthy "carriers" that is to say, by healthy persons who
harbour virulent diphtheria bacteria chiefly in their throats or noses or both, these
bacilli are often passed on during the act of coughing or even loud speaking, or perhaps
for a very short distance by ordinary breathing, especially in the case of overcrowded
vehicles or passenger lifts, or by means of incompletely cleansed drinking
vessels or eating utensils placed in the mouth such as spoons, forks, etc.
Anti-diphtheria immunisation is worthy of an extensive trial. The procedure
has already gained wide acceptance in the United States of America; other
countries nearer home, such as Germany, France and Belgium are immunising
their children in this way. In these islands it has proved its worth as a means
of preventing diphtheria in hospital nurses and in stamping out diphtheria in
institutions where the disease has been present for a considerable time and has
given rise to case after case. The Edinburgh statistics relating to school children
are, to say the least, very encouraging. The control of smallpox obtained by
vaccination is so complete that progressive members of the medical profession
have been stimulated to obtain a similar control of other infectious diseases
including not only diphtheria, but also scarlet fever and measles, and the measure
of success already obtained in controlling diphtheria warrants further effort.
Less Diphtheria in Holborn than in London.
The following table shows the diphtheria notification rates in England and
Wales, London, and Holborn during the six years 1922-27. As the Schick test
and immunisation against diphtheria were started in Holborn in the early part of
1922 the figures are of interest:—