View report page

82
Immunization Scheme.
The following report is submitted by Dr. P. Y. Pritchard, the Deputy Medical Officer
of Health :—
The scheme for immunizing children against Diphtheria was put into operation in
October, 1936. Certain [alterations to the original arrangements were found necessary and
these have been made.
Immunization is provided for children between 1 and 13 years of age whose parents
are not earning more than £400 a year. The Borough Council pays the family doctor for
giving the immunizing injections a fee of 7s. 6d. per case and provides him with the necessary
material. After careful investigation it was decided to use toxoid-antitoxin floccules because
of its reputation for a low incidence of unwanted or unspecific reactions. This T.A.F. is given
in three injections at fortnightly intervals. The Council pays 4s. per set of the three doses.
The Schick test is a method of finding out whether a person is immune to Diphtheria.
It may be performed in the first place to see whether the course of immunizing injections is
necessary. As children between 1 and 5 are so very liable to the infection, it is recommended
that they should all be immunized, and no preliminary Schick test is necessary for this age
group.
After 5 years of age the incidence of the disease becomes lower and many children
develop an immunity in a natural way. The preliminary test is therefore valuable to distinguish
these protected children from those who have not developed the protection and who
therefore require the artificial method of immunization. Schick testing three months after the
last of the three injections of T.A.F. is very necessary, as a small percentage of children fail to
develop a complete protection with one course of three injections. The post immunization Schick
test detects these children, who are then directed to have a further course of T.A.F., and who
would otherwise have been thought to be protected when such was not the case. For this
reason it is most important that parents should have this post Schick examination performed.
All Schick testing is done at special clinics and at suitable institutions by the Deputy Medical
Officer of Health in his capacity as Diphtheria Immunization Officer. This officer is also
responsible for the general administration of the scheme.
There are 78 Medical Practitioners on the approved panel. At the end of the year
731 children were reported to have received or to be in the process of receiving immunization
under the scheme. During 1937 there were 1073 attendances at the Schick Testing Clinics.
Diphtheria immunization is nearly 100 per cent, successful in preventing the disease
in individuals. A scheme such as the one in St. Pancras aims at protecting the community.
In order to reduce the liability of the community to Diphtheria infection it will be necessary
for a high proportion of all susceptible children to be immunized at the earliest possible date,
and for this " saturated " state to be maintained by immunizing all children directly after
infancy.
ENTERIC OR TYPHOID FEVER.
Two cases of Typhoid and eight cases of Para B. Typhoid were notified during the
year. Two diagnoses of Typhoid were not confirmed. There was one death.
PUERPERAL PYREXIA AND PUERPERAL FEVER.
In 1937 there were 30 notifications of Puerperal Pyrexia and 14 notifications of
Puerperal Fever. Further details of these diseases are given on page 138 of the Maternity
and Child Welfare Section.