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Diphtheria Carriers.—There is a clinic for diphtheria carriers held at St. Mary's Hospital, to
which 4 cases were referred by the Public Health Department during the past year.
Anti-Diphtheritic Serum.—This is stocked at the Town Hall and supplied to medical practitioners
on request for the use of patients resident in the Borough who are too poor to obtain such serum
privately. During the year 12 phials of 8,000 units, 14 phials of 4,000 units, 11 phials of 1,000
units, and 14 phials of 500 units, were distributed.
Diphtheria Immunisation.—A Clinic was inaugurated at the Welfare Centre, 232, Harrow Road,
in 1933, for the immunisation of children against diphtheria, and is at present in the charge of the
Assistant Medical Officer for Maternity and Child Welfare (Dr. Emslie).
Towards the end of 1934 the Council, after consultation with local representatives of the medical
profession, decided to introduce a scheme for enlisting the services of private medical practitioners
in the work of diphtheria immunisation. The scheme provides for the payment to the practitioner
of a fee of 10s. for immunising treatment given to any child between the ages of one year and twelve
years, whose parent or guardian cannot reasonably be expected to afford a private fee for such
treatment. All Schick testing for the purpose of ascertaining whether the child is susceptible to
diphtheria is to be done by the Medical Officer of the Council's diphtheria immunisation clinic at
the Welfare Centre, No. 232, Harrow Road. In the case of a child sent to the clinic for a preimmunisation
test, the result of which is negative, a fee of 2s. 6d. only is payable to the practitioner.
The practitioner is required to bear the cost of an immunising agent specified by the Medical Officer
of Health, and he is also responsible for any subsequent medical attention that may be necessary.
The Public Health Committee reported as follows to the Council on the 29th May, 1937:—
"We have had under consideration the steps to be taken to give greater publicity to
immunisation against diphtheria, together with the action taken herein by the other Metropolitan
Boroughs.
Anti-diphtheria immunisation was inaugurated by the Council in June, 1933, and at the
end of 1934 the Scheme was extended by the enlistment of the services of private doctors.
The yearly record of individuals who were fully protected is as follows :—1933—at clinics
—54 ; 1934—at clinics—225 ; 1935—-at clinics—130, by private doctors—276 ; 1936—at
clinics—73, and by private doctors—129.
There exists a great deal of apathy and even antipathy to this kind of immunisation. It
has been found in other areas that intensive propaganda work can break down a certain amount
of this resistance ; but it has to be continued, and, even then, there will remain a large proportion
of the population which cannot be induced to submit to the necessary testings and inoculations.
Up to the present, most of the propaganda has been personal, and directed to parents, by
health visitors, welfare centre doctors and private doctors. Publicity has also been obtained
by the exhibition of posters at the Welfare Centres, and by the distribution of leaflets in the
schools and by private doctors to their own patients. Recently, posters have been exhibited
at the Council's Establishments (Libraries, Baths, Recreation Ground, etc.) and on the street
orderly bins. We propose to continue this form of publicity and to issue birthday cards as
in some other Boroughs. These take the form of a Greeting posted to each child in the Borough
on its attaining one year of age, the message incorporating information for the parents as to
the advantages of immunisation."
The sending of birthday cards commenced on the 1st November.
The following report has been received from Dr. Emslie on the work carried out at the Clinic
during the year:—
" The figures for the Diphtheria Immunisation Clinic are to be found below. The Clinic
has been in existence since 1933, but the response of parents has been disappointing. Up to
the end of 1937 1,068 cases have been inoculated and rendered Schick negative, and 284 cases
have been found on testing to be naturally immune. While this is of great benefit to the
individuals concerned, the numbers are far too small to have any effect on the community as
a whole. It has been estimated that at least 35% to 50% of the population under 10 years, evenly
distributed, must be immunised if diphtheria is to be eliminated from the community."