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Conclusions.—The question of protecting the community from Diphtheria by Schick
treatment is a difficult one, but the work at Newport Market School demonstrated clearly
that a small community of this nature could very readily be protected. The work occupied
only a few hours in all, and there were no harmful results, nor was there any interruption
of the school work.
In the 15 months between the two series of tests 31 new boys joined the school,
arriving singly at irregular intervals. Thus about one-third of the personnel of the school
changes annually. To keep the school protected would need fairly frequent treatment of
new boys, but this could readily be done by a school medical officer. If done every four
months there would be about 8 or 10 boys each time, and the re-testing of the batch before
could be done at the same time. Under such a system there would never be more than a
few boys unprotected at one time. Better still would be to treat each boy on arrival,
but it is easier to deal with them in batches.
At the end of October the work at the Child Welfare Centres was started. It was
thought best to begin with one Centre only, and the Bessborough Street Centre was
chosen as, owing to the small epidemic of Diphtheria during the previous year, it was felt
that the importance of the work would readily be appreciated. Owing to the excellent
co-operation of the Health Visitors at the Centre there was no difficulty in finding parents
who wished their children treated. Twenty-two cases were tested before the end of the
year, of whom 17 were positive and received treatment, and many inquiries were being
made by parents desiring treatment for their children in the following year.
It was found that the treatment can readily be carried out at a Child Welfare Centre,
that it was well tolerated by the children and without unpleasant after-effects.
Particularly noteworthy was the interest displayed by many of the mothers, and
their eagerness to have any treatment which would mitigate the dangers of Diphtheria."
Ian S. Thomson.
Antitoxin, for use in cases of diphtheria, is provided free of charge
for medical practitioners attending patients residing in the City. The
supply is available on application at the City Hall, and at the Council's
Mortuary in Horseferry Road. It is apparent, however, from the small
amount used (36 bulbs, each containing 8,000 units), that practitioners
prefer to send their patients at once into the fever hospitals, where antitoxin
is administered on admission to all cases of clinical diphtheria.
In times of epidemic, however, when the capacity of the fever hospitals is
greatly taxed, there tends to be delay in admitting cases, and it is then
that practitioners make full use of the antitoxin supplied by the Council.
Bacteriological Diagnosis.— Swabs from suspected cases among
those residing in the City can be examined by the Council's bacteriologist
free of charge to the practitioners attending. The materials for swabbing
are supplied by the Council, and reports are in the first instance telephoned
or telegraphed to the doctor concerned, and written reports follow. The
number of throat swabs examined by the Council's bacteriologist during
each year since 1922 were:—
1922 1923 1924 . 1925 1926
456 281 556 674 679
Enteric Fever.—There were 11 cases of typhoid and paratyphoid
which came to the knowledge of the department during 1926. Of these
4 were notified as paratyphoid and 7 were typhoid. Of the 4 paratyphoid