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86
Public Health (Smallpox Prevention) Regulations, 1917.
No vaccinations were performed by the Medical Officer of
Health under the Public Health (Smallpox Prevention) Regulations,
1917.
Diphtheria.
There were 103 more cases of diphtheria notified than in the
previous year and the incidence per 1,000 population rose from
1.85 to 2.23 in 1938. The case mortality dropped from 3.94 per
cent. to 1.96 per cent. a decrease of 50 per cent.
The two diphtheria prevention clinics were better attended
than in the previous year but the number immunised is still far
too small to affect to an appreciable extent the incidence among
the population. In view of the greater efficiency of alum
precipitated toxoid compared with toxoid antitoxin mixture
shown in the annual report of 1936, both clinics now use the former
almost exclusively.
One case was admitted to hospital with a sore throat of two days
duration and a positive swab result after immunisation. Clinically
the condition was a follicular tonsillitis with a temperature of 103°.
The Dick reaction was positive but a striptococcal tonsillitis
associated with a diphtheria carrier condition was excluded;
antidiphtheritic serum was given as a precaution and the case
cleared up in five days.
The modified clinical picture and rapid disappearance of
diphtheria bacilli were almost certainly attributable to the partial
immunity resulting from the prophylactic injections.