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It is of interest that of the 10 cases under 5 who were negative, 7 had
definitely been in contact with cases of diphtheria in the family, and
may in this way have acquired immunity in resisting small doses of
infection. This bears out what has been found elsewhere, that the test
is hardly necessary under five years, if there has been no contact with
diphtheria. It is proposed in future to increase the number treated
without a preliminary test. It has been found, however, that many
parents prefer to have susceptibility demonstrated by the test before
treatment is started.
The table also shows the increase of immunity with age. Between
5 and 10, 64 per cent, only and over 10, about 50 per cent, are positive.
In a small percentage of cases only, reactions after treatment were
reported, especially among the older children. Most of these cases complained
of slight malaise or discomfort and in five or six cases, there
were rather more severe general or local reactions. These were invariably
transient reactions, being confined to the two or three days following a
prophylactic injection. In one or two cases reactions followed each
injection, in many others it occurred only after one, usually the first.
It must also be recognised that in an occasional case the child or the
mother is temperamentally unsuitable for the treatment and that it is
probably wise to abandon the treatment in these rare cases.
The number of patients attending for retests has been higher than in
the previous year and about 60 per cent, of those who have received
prophylactic treatment since the scheme started and who were due for
retesting, have received retests. Some of the others may still attend,
and a number leave the district before the rctest is due. Ninety-eight
were retested during 1028, of whom 89 gave a negative result. Nine
gave slight positive or doubtful results and eight of these, after the
parents had been consulted, received two additional protecting doses.
No retest gave a marked positive result.
One child was removed to hospital, six months after a negative retest,
with definite clinical and bacteriological diphtheria. It appears probable