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The above table shows that only three of the children were retested after
the last injection. It cannot be assumed that immunity invariably follows the
administration of three immunising injections, nor that immunity even when
once established is invariably permanent. Drs. Parish and Okell have shown
that of 440 Schick positive children who were rendered Schick negative by
immunisation, 5 per cent. were found to be positive when re-tested 1-7 years later.
Diphtheria in Children Treated with Immunising Injections.
Up to the end of the year 1935 twelve cases of diphtheria occurred in children
who had been treated with three immunising injections; the details of these are
given in Table III. Diphtheria was also notified as having occurred in two
children who had been found negative to a first Schick test, but the diagnosis was
not confirmed.
Diphtheria was also notified as having occurred in fifteen 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
hospital as suffering from diphtheria, but they were diagnosed as suffering from
rubella and "carrying" diphtheria bacilli but not suffering from diphtheria. A
third child was removed with diphtheria and found to have measles. Two cases
removed with diphtheria were returned as cases of coryza, not diphtheria; a sixth
was removed with faucial diphtheria, but the diagnosis was not confirmed. A
seventh was removed with diphtheria but was found to be a case of follicular
tonsillitis. An eighth was notified as a case of nasal diphtheria, but the diagnosis
was not confirmed, and the child was not removed to hospital.
All these children had been found negative to the retest some time previously.
Five others were removed to L.C.C. hospitals as suffering from diphtheria, but
were shortly afterwards discharged as being not cases; neither had been re-Schicked
since being inoculated; one case after return from hospital gave a negative reaction
to the re-Schick test. The thirteenth was notified as suffering from scarlet fever
and diphtheria, but was later diagnosed as suffering from scarlet fever only; the
fourteenth and fifteenth, also removed to hospital as suffering from diphtheria,
were returned as cases of catarrhal sore throat and not diphtheria.
One adult who had been retested after immunisation was removed with
diphtheria, but the diagnosis was not confirmed.
One case of nasal diphtheria occurred in an adult who had been found negative
to a first Schick test.
Four adults who had completed their course of inoculation but had not been
retested were removed to L.C.C. hospitals as suffering from diphtheria, but were
returned as not diphtheria; one was suffering from follicular tonsillitis and one
from tonsillitis; in one there was no evidence of clinical diphtheria, but the
patient had virulent diphtheria bacilli in the throat; in the fourth the diagnosis
w as not confirmed.
Immunisation of Nursing Staff at the London Homoeopathic Hospital.
The arrangements made in June, 1930, with the authorities of the London
Homoeopathic Hospital for the Medical Officer of the Council's Immunisation Clinic
to Schick test and immunise the nursing staff was continued during 1935.
At this hospital Schick testing of all newcomers and immunisation of positives
is now customary.