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74
The question of the aclvisibility of using T. A.M. from a bottle that has already
been opened has arisen from time to time. In Holborn to save waste we buy
T. A.M. in a bottle containing 25 c.c. which is a quantity in excess of that which
we are likely to use at one session.
This procedure has been found to be safe; every week as a routine aerobic and
anferobic cultures are made from the bottle of toxoid anti-toxin mixture in use; no
organism has ever grown.
What of the Future ?
The aim of everyone who takes up the work must be to get all the children living
in the area immunised as soon as possible after they reach the age of 6 months. In
Holborn we have not reached this stage yet; the history of vaccination against small
pox suggests we never shall. But a local health authority is justified in considering
that it has done all in its power to prevent loss of life and illness from diphtheria if it
offers immunisation, supported by necessary advice and information to parents.
It might be expected that if the immunisation were carried out among the
school population in a large town the parents would come to regard the procedure
as more ordinary, and be prepared to allow the younger children to be immunised
at infant welfare centres. Apparently it cannot be too often repeated that it is
immunisation at a very early age that we want carried out; if it is delayed till
school age half the deaths will have occurred.
Immunisation of School Children against Diphtheria.
The decision of the London County Council not yet to take up the matter of
diphtheria immunisation in the schools though willing to help the work started in
the various boroughs, by affording facility in the schools for the circularisation of
information to parents, was somewhat of a disappointment to several Medical
Officers of Health of Metropolitan Boroughs. Where a Borough Council has
definitely decided in favour of diphtheria immunisation and offers it to children
under five years of age, each young child is brought to the Immunisation Centre as
a result of individual effort, but the organisation of a public elerrentary school
lends itself so easily to the mass immunisation of a large body of children that it
seems very unfortunate that the Borough who has approved the principle should
lose this advantage.
Diphtheria at Different Ages.
As a matter of interest and in response to many enquiries we have taken out
the age-incidence of attacks of diphtheria (notifications) in the County of London
during recent years.