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In addition to the above 12 others Schick tested in 1924 were still undergoing
immunisation at the end of the year. Eighteen others Schick tested in
1923 completed immunisation in 1924.
Those found to be Schick positive are given three inoculations of 1 ccm. of
toxin-anti-toxin (T.A.T.) on three consecutive Wednesdays; after some weeks
have elapsed all those who have completed the routine attendances should attend
again for re-testing.
As a rule, those found positive to Schick testing who do not begin inoculations,
are children whose fathers will not give their consent to immunisation.
During 1924, 217 persons (208 children and 9 adults) were tested; 166 were
positive, 50 negative, and one was not able to re-attend for reading, or to be seen
at home; 41 failed to complete, or did not begin, the attendances for immunisation.
Experience leads us to believe that many of these will complete their attendance
in 1925.
Eleven children were given 3 ccms. T.A.T. in smaller doses to avoid possible
reaction, the occurrence of a very marked positive Schick reaction being taken
as an indication of probable sensitiveness to protein.
When the matter of immunisation against diphtheria is discussed attention
is concentrated on the immunisation of school children. This is unfortunate.
In the report for 1922 it was shown that in London 52'6 per cent, of the deaths
from diphtheria in the three years 1919-1921 occurred in children under five years;
immunisation should not be delayed until the child is of school age.
Scarlet Fever.
All the 88 cases of scarlet fever were removed to hospital. Five cases
were returned from hospital "not scarlet fever."
In connection with 6 of the cases during the year there were 8 secondary
cases. All of these were notified either at the same time or within a few days
of the primary case. These secondary cases are exclusive of two nurses at a
hospital in the Borough who were notified as suffering with scarlet fever; from
tne same hospital 28 in-patients were notified as suffering with the disease; none
of these in-patients were residents of Holborn. There was no "return" case,
i.e., a case of scarlet fever occurring within 28 days of the return from hospital to
the same house of a previous case of scarlet fever.
There was one death from scarlet fever.
11,610 cases of scarlet fever were notified in London with 129 deaths.
Enteric Fever.
Two cases were notified during the year.
In one case the illness was contracted whilst the patient was travelling from
Australia to England via Canada. This patient died in hospital outside the
Borough. As the patient's home address was in Australia the death was not
transferred to Holborn. In the second case the patient was an Italian taking all
meals, except supper, at various eating houses.
410 cases were notified in London, with 52 deaths.