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No signs of reaction were noted when the patients were seen a week
after treatment, but a small proportion reported some slight disturbance
a day or two after the injection. Usually, in these cases, the mother
stated the child seemed cross or tired, or that the arm was uncomfortable.
In 5 cases, none of them young children, rather more definite reactions
were reported, but only one of these discontinued treatment, so the parents
evidently did not take a serious view of these transient reactions. One
child had some swelling of the arm with slight temperature after each
injection, while her sister, receiving identical treatment, showed no effects.
The fact that only 4 out of the 274 cases abandoned the treatment
indicates the interest taken by the parents, for one must realise that, to
bring a child up on four successive weeks, entails a good deal of trouble.
In a few cases the treatment was interrupted, but completed later. A
number of parents who attended regularly during the treatment appear to
have difficulty in realising the importance of returning to have the
children re-tested, however. In other cases the children left Westminster
before the re-test was due.
Thirty cases dealt with (about 11 per cent.) had not been vaccinated.
It is of some interest that such a considerable proportion had evaded
compulsory vaccination and yet were willing to consider this voluntary
preventive treatment. This may be partly due to the fact that the
dangers of Diphtheria are better known to the present generation in
London than those of Smallpox. It also suggests that the method adopted
of simply explaining the proposed treatment and leaving the decision
with them appeals to a certain type of parent.
Ian S. Thomson,
Assistant Medical Officer of Health.
2nd May, 1928.
AMitoxin, 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 (12 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