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Investigation of multiple cases—that is, several cases occurring more or less together
in one house —shows that in 12 families there were two such cases, in seven families three
such cases, in one family four such cases, and in one family six such cases in each home.
Antitoxin for the treatment of necessitous cases of this disease is supplied to medical
practitioners free of charge by the Council. During the year 98 thousand units were
provided.
If, in the course of the next few weeks after leaving hospital, any alteration of voice,
defect in the sight, difficulty in swallowing, or loss of power in limbs or tendency to faintness
should be observed in a patient who has had diphtheria, a doctor should be consulted at once.
It is recommended to the friends of patients discharged from hospital after suffering
from diphtheria:—
1. That, if practicable, for three weeks after leaving hospital, the patient should not
sleep in the same bed as children who have not had diphtheria.
2. That during this period articles used by the patient (such as cup, plate, spoon,
handkerchiefs, towels and toys) should be kept distinct from those used by other children.
That the patient should not attend school for two weeks.
The above precautions are specially important in the case of those patients who have a
discharge from either nose or ears.
Immunization Scheme.
The following report is submitted by Dr. P. V. 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.